Hardtner Medical Center
Listed in its price file as “LaSalle Parish Hospital Service District No. 1”.
Hardtner Medical Center in Olla, LA publishes cash prices for 339 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Louisiana median for 293 of 335 procedures and below it for 41. By typical cash price it ranks #60 of 63 Louisiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1102 N Pine Road, Olla, LA 71465 Collected Sep 22, 2026 Source price file Check a bill from this hospital (318) 495-3131
Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CCN 191315 · CMS hospital register NPI 1639263189
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Hardtner Medical Center is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast | $2,858.40 | $3,573.00 | — | 188% above | 20% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast | $2,858.40 | $3,573.00 | — | — | 20% |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views | $381.60 | $477.00 | — | 119% above | 20% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views | $381.60 | $477.00 | — | — | 20% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral | $339.20 | $424.00 | — | — | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Left | $227.20 | $284.00 | — | 100% above | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Right | $227.20 | $284.00 | — | 100% above | 20% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral | $339.20 | $424.00 | — | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Right | $227.20 | $284.00 | — | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Left | $227.20 | $284.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Forearm w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Scapula w/o Contrast Bilat | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Wrist w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Elbow w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Humerus w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Shoulder w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Hand w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Clavicle w/o Contrast Bilat | $2,700.80 | $3,376.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Scapula w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Finger(s) w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Scapula w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Clavicle w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Finger(s) w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Clavicle w/o Contrast Right | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Left | $1,801.60 | $2,252.00 | — | 186% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right | $2,725.60 | $3,407.00 | — | 333% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Humerus w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Forearm w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Scapula w/o Contrast Bilat | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Wrist w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Shoulder w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Hand w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Elbow w/o Contrast Bilateral | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Clavicle w/o Contrast Bilat | $2,700.80 | $3,376.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Clavicle w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Clavicle w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Finger(s) w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Finger(s) w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Scapula w/o Contrast Left | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Scapula w/o Contrast Right | $1,801.60 | $2,252.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Right | $2,725.60 | $3,407.00 | — | — | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right | $508.00 | $635.00 | — | 204% above | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left | $508.00 | $635.00 | — | 204% above | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right | $508.00 | $635.00 | — | — | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left | $508.00 | $635.00 | — | — | 20% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis | $3,024.00 | $3,780.00 | — | 238% above | 20% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis | $3,024.00 | $3,780.00 | — | — | 20% |
| CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head | $1,648.80 | $2,061.00 | — | 150% above | 20% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head | $1,648.80 | $2,061.00 | — | — | 20% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Neck | $1,648.80 | $2,061.00 | — | 150% above | 20% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck | $1,648.80 | $2,061.00 | — | — | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest | $2,315.20 | $2,894.00 | — | 185% above | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Chest PE Protocol | $2,431.20 | $3,039.00 | — | 200% above | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest | $2,315.20 | $2,894.00 | — | — | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Chest PE Protocol | $2,431.20 | $3,039.00 | — | — | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $1,135.20 | $1,419.00 | — | 3% above | 20% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast | $1,135.20 | $1,419.00 | — | — | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast | $2,164.00 | $2,705.00 | — | 96% above | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast | $2,164.00 | $2,705.00 | — | — | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $3,492.80 | $4,366.00 | — | 146% above | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $3,492.80 | $4,366.00 | — | — | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $2,514.40 | $3,143.00 | — | 202% above | 20% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $2,514.40 | $3,143.00 | — | — | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $1,713.60 | $2,142.00 | — | 131% above | 20% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $1,713.60 | $2,142.00 | — | — | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $1,915.20 | $2,394.00 | — | 207% above | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $1,915.20 | $2,394.00 | — | — | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast | $1,401.60 | $1,752.00 | — | 114% above | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head Stroke Protocol | $1,401.60 | $1,752.00 | — | 114% above | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast | $1,401.60 | $1,752.00 | — | — | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head Stroke Protocol | $1,401.60 | $1,752.00 | — | — | 20% |
| CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast | $1,844.00 | $2,305.00 | — | 157% above | 20% |
| CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast | $1,844.00 | $2,305.00 | — | — | 20% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast | $2,200.80 | $2,751.00 | — | 146% above | 20% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast | $2,200.80 | $2,751.00 | — | — | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $1,823.20 | $2,279.00 | — | 143% above | 20% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $1,823.20 | $2,279.00 | — | — | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $1,832.80 | $2,291.00 | — | 161% above | 20% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $1,832.80 | $2,291.00 | — | — | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $1,953.60 | $2,442.00 | — | 144% above | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast | $1,953.60 | $2,442.00 | — | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast | $2,888.00 | $3,610.00 | — | 181% above | 20% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/ + w/o Contrast | $2,888.00 | $3,610.00 | — | — | 20% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $272.80 | $341.00 | — | 117% above | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $272.80 | $341.00 | — | — | 20% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View | $200.00 | $250.00 | — | 94% above | 20% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View | $200.00 | $250.00 | — | — | 20% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR Clavicle Bilat | $412.00 | $515.00 | — | — | 20% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $275.20 | $344.00 | — | 141% above | 20% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $275.20 | $344.00 | — | 141% above | 20% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR Clavicle Bilat | $412.00 | $515.00 | — | — | 20% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right | $275.20 | $344.00 | — | — | 20% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left | $275.20 | $344.00 | — | — | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $389.60 | $487.00 | — | 42% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $389.60 | $487.00 | — | — | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $250.40 | $313.00 | — | 73% above | 20% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton | $250.40 | $313.00 | — | — | 20% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton | $248.80 | $311.00 | — | 214% above | 20% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton | $248.80 | $311.00 | — | — | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast | $1,830.40 | $2,288.00 | — | 173% above | 20% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast | $1,830.40 | $2,288.00 | — | — | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast | $2,282.40 | $2,853.00 | — | 171% above | 20% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast | $2,282.40 | $2,853.00 | — | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $904.80 | $1,131.00 | — | — | 20% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR Elbow Complete 3+ Views Bilateral | $590.40 | $738.00 | — | — | 20% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Left | $392.80 | $491.00 | — | 200% above | 20% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Right | $392.80 | $491.00 | — | 200% above | 20% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR Elbow Complete 3+ Views Bilateral | $590.40 | $738.00 | — | — | 20% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Right | $392.80 | $491.00 | — | — | 20% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Left | $392.80 | $491.00 | — | — | 20% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits Sella w/o Contrast | $2,384.80 | $2,981.00 | — | 293% above | 20% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits Sella w/o Contrast | $2,384.80 | $2,981.00 | — | — | 20% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views | $429.60 | $537.00 | — | 192% above | 20% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views | $429.60 | $537.00 | — | — | 20% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR Forearm 2 Views Bilateral | $416.00 | $520.00 | — | — | 20% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left | $275.20 | $344.00 | — | 144% above | 20% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right | $275.20 | $344.00 | — | 144% above | 20% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR Forearm 2 Views Bilateral | $416.00 | $520.00 | — | — | 20% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left | $275.20 | $344.00 | — | — | 20% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right | $275.20 | $344.00 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR Calcaneus Bilateral | $405.60 | $507.00 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left | $271.20 | $339.00 | — | 149% above | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right | $271.20 | $339.00 | — | 149% above | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR Calcaneus Bilateral | $405.60 | $507.00 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Left | $271.20 | $339.00 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Right | $271.20 | $339.00 | — | — | 20% |
| Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral | $742.40 | $928.00 | — | — | 20% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $372.80 | $466.00 | — | 176% above | 20% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $372.80 | $466.00 | — | 176% above | 20% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral | $742.40 | $928.00 | — | — | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left | $372.80 | $466.00 | — | — | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right | $372.80 | $466.00 | — | — | 20% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 XR Knee Complete 4+ Views Bilateral | $645.60 | $807.00 | — | — | 20% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Right | $429.60 | $537.00 | — | 194% above | 20% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Left | $429.60 | $537.00 | — | 194% above | 20% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR Knee Complete 4+ Views Bilateral | $645.60 | $807.00 | — | — | 20% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Right | $429.60 | $537.00 | — | — | 20% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Left | $429.60 | $537.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Ankle w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Lower Leg w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Femur w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Hip w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Knee w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Foot w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Right | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Left | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Right | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Left | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Calcaneus w/o Contrast Right | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Calcaneus w/o Contrast Left | $1,953.60 | $2,442.00 | — | 227% above | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Lower Leg w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Foot w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Hip w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Knee w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Femur w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Ankle w/o Contrast Bilateral | $3,402.40 | $4,253.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Right | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Left | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Left | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Right | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Left | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Right | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Left | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Right | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Left | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Right | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Calcaneus w/o Contrast Left | $1,953.60 | $2,442.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Calcaneus w/o Contrast Right | $1,953.60 | $2,442.00 | — | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 US Abdomen/Lower Back Limited | $567.20 | $709.00 | — | 127% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 76705 US Abdomen/Lower Back Limited | $567.20 | $709.00 | — | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Extremity Nonvascular Limited Bilat | $597.60 | $747.00 | — | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Right | $783.20 | $979.00 | — | 351% above | 20% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Left | $783.20 | $979.00 | — | 351% above | 20% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Extremity Nonvascular Limited Bilat | $597.60 | $747.00 | — | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Right | $783.20 | $979.00 | — | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Left | $783.20 | $979.00 | — | — | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Screening | $280.80 | $351.00 | — | 90% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Screening | $280.80 | $351.00 | — | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR Tibia/Fibula Bilateral | $396.00 | $495.00 | — | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right | $264.80 | $331.00 | — | 131% above | 20% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left | $264.80 | $331.00 | — | 131% above | 20% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR Tibia/Fibula Bilateral | $396.00 | $495.00 | — | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left | $264.80 | $331.00 | — | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right | $264.80 | $331.00 | — | — | 20% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast | $2,724.00 | $3,405.00 | — | 224% above | 20% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast | $2,724.00 | $3,405.00 | — | — | 20% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral. | $1,112.00 | $1,390.00 | — | — | 20% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral. | $1,112.00 | $1,390.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Ankle w/o Contrast Bilateral | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Knee w/o Contrast Bilateral | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hip w/o Contrast Bilateral | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $2,344.00 | $2,930.00 | — | 170% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $2,344.00 | $2,930.00 | — | 170% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $2,344.00 | $2,930.00 | — | 170% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $2,344.00 | $2,930.00 | — | 170% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $2,344.00 | $2,930.00 | — | 170% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $2,344.00 | $2,930.00 | — | 170% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Knee w/o Contrast Bilateral | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Hip w/o Contrast Bilateral | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Ankle w/o Contrast Bilateral | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $2,344.00 | $2,930.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Hip w/ + w/o Contrast Bilateral | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Knee w/+ w/o Contrast Bilateral | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Ankle w/ + w/o Contrast Bilateral | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $3,002.40 | $3,753.00 | — | 142% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $3,002.40 | $3,753.00 | — | 142% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $3,002.40 | $3,753.00 | — | 142% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $3,002.40 | $3,753.00 | — | 142% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $3,002.40 | $3,753.00 | — | 142% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $3,002.40 | $3,753.00 | — | 142% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Ankle w/ + w/o Contrast Bilateral | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Knee w/+ w/o Contrast Bilateral | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Hip w/ + w/o Contrast Bilateral | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $3,002.40 | $3,753.00 | — | — | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP | $3,360.00 | $4,200.00 | — | 274% above | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP | $3,360.00 | $4,200.00 | — | — | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $3,245.60 | $4,057.00 | — | 159% above | 20% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $3,245.60 | $4,057.00 | — | — | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast Stroke Protocol | $1,389.60 | $1,737.00 | — | 41% above | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $2,472.00 | $3,090.00 | — | 152% above | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast Stroke Protocol | $1,389.60 | $1,737.00 | — | — | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $2,472.00 | $3,090.00 | — | — | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $3,158.40 | $3,948.00 | — | 142% above | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $3,158.40 | $3,948.00 | — | — | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $2,135.20 | $2,669.00 | — | 107% above | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $2,135.20 | $2,669.00 | — | — | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $3,089.60 | $3,862.00 | — | 127% above | 20% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $3,089.60 | $3,862.00 | — | — | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $2,136.00 | $2,670.00 | — | 145% above | 20% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast | $2,136.00 | $2,670.00 | — | — | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $3,158.40 | $3,948.00 | — | 135% above | 20% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $3,158.40 | $3,948.00 | — | — | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $2,126.40 | $2,658.00 | — | 127% above | 20% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast | $2,126.40 | $2,658.00 | — | — | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $3,240.80 | $4,051.00 | — | 216% above | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast | $3,240.80 | $4,051.00 | — | — | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $2,183.20 | $2,729.00 | — | 169% above | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $2,183.20 | $2,729.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Wrist w/o Contrast Bilateral | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Elbow w/o Contrast Bilateral | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Shoulder w/o Contrast Bilateral | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $2,288.80 | $2,861.00 | — | 187% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $2,288.80 | $2,861.00 | — | 187% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $2,288.80 | $2,861.00 | — | 187% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $2,288.80 | $2,861.00 | — | 187% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $2,288.80 | $2,861.00 | — | 187% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $2,288.80 | $2,861.00 | — | 187% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Elbow w/o Contrast Bilateral | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Shoulder w/o Contrast Bilateral | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Wrist w/o Contrast Bilateral | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $2,288.80 | $2,861.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $2,288.80 | $2,861.00 | — | — | 20% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrast | $2,257.60 | $2,822.00 | — | 231% above | 20% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrast | $2,257.60 | $2,822.00 | — | — | 20% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Contrast | $1,811.20 | $2,264.00 | — | 172% above | 20% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Contrast | $1,811.20 | $2,264.00 | — | — | 20% |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $280.80 | $351.00 | — | 146% above | 20% |
| Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue | $280.80 | $351.00 | — | — | 20% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast | $1,716.80 | $2,146.00 | — | 162% above | 20% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast | $1,716.80 | $2,146.00 | — | — | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Non OB Ltd | $612.80 | $766.00 | — | 300% above | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Non OB Ltd | $612.80 | $766.00 | — | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non OB Comp | $677.60 | $847.00 | — | 147% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Non OB Comp | $677.60 | $847.00 | — | — | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Comp 2nd Trimester Survey | $727.20 | $909.00 | — | 214% above | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Comp 2nd Trimester Survey | $727.20 | $909.00 | — | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 Weeks Single | $578.40 | $723.00 | — | 177% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Than 14 Weeks Single | $578.40 | $723.00 | — | — | 20% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Right | $313.60 | $392.00 | — | 136% above | 20% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Left | $313.60 | $392.00 | — | 136% above | 20% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Right | $313.60 | $392.00 | — | — | 20% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Left | $313.60 | $392.00 | — | — | 20% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screening Bilateral | $239.20 | $299.00 | — | — | 20% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Implant Digital Screening Bilat | $239.20 | $299.00 | — | — | 20% |
| Screening mammogram, both breasts CPT 77067 77067 Mammo Add-On | $239.20 | $299.00 | — | 82% above | 20% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Implant Digital Screening Bilat | $239.20 | $299.00 | — | — | 20% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screening Bilateral | $239.20 | $299.00 | — | — | 20% |
| Screening mammogram, both breasts inpatient CPT 77067 77067 Mammo Add-On | $239.20 | $299.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Complete 2+ Views Bilat | $436.80 | $546.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Right | $292.80 | $366.00 | — | 130% above | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Left | $292.80 | $366.00 | — | 130% above | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Complete 2+ Views Bilat | $436.80 | $546.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Right | $292.80 | $366.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Left | $292.80 | $366.00 | — | — | 20% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete | $372.80 | $466.00 | — | 142% above | 20% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete | $372.80 | $466.00 | — | — | 20% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views | $356.80 | $446.00 | — | 203% above | 20% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views | $356.80 | $446.00 | — | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR Femur 2 Views Bilat | $420.00 | $525.00 | — | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Right | $280.80 | $351.00 | — | 147% above | 20% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Left | $280.80 | $351.00 | — | 147% above | 20% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR Femur 2 Views Bilat | $420.00 | $525.00 | — | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Right | $280.80 | $351.00 | — | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Left | $280.80 | $351.00 | — | — | 20% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast | $1,830.40 | $2,288.00 | — | 150% above | 20% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast | $1,830.40 | $2,288.00 | — | — | 20% |
| Toe X-ray, 2 or more views both sides CPT 73660 XR Toe(s) 2+ Views Bilat | $485.60 | $607.00 | — | — | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Left | $323.20 | $404.00 | — | 201% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Right | $323.20 | $404.00 | — | 201% above | 20% |
| Toe X-ray, 2 or more views inpatient both sides CPT 73660 XR Toe(s) 2+ Views Bilat | $485.60 | $607.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Left | $323.20 | $404.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Right | $323.20 | $404.00 | — | — | 20% |
| Transvaginal pelvic ultrasound CPT 76830 HMLA US TRANSVAGINAL NON-OB | $671.20 | $839.00 | — | 245% above | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $671.20 | $839.00 | — | 245% above | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HMLA US TRANSVAGINAL NON-OB | $671.20 | $839.00 | — | — | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $671.20 | $839.00 | — | — | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $728.80 | $911.00 | — | 145% above | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $728.80 | $911.00 | — | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck | $655.20 | $819.00 | — | 160% above | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck | $655.20 | $819.00 | — | — | 20% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR Humerus Bilat | $436.80 | $546.00 | — | — | 20% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left | $292.80 | $366.00 | — | 158% above | 20% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right | $292.80 | $366.00 | — | 158% above | 20% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR Humerus Bilat | $436.80 | $546.00 | — | — | 20% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right | $292.80 | $366.00 | — | — | 20% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left | $292.80 | $366.00 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right | $680.00 | $850.00 | — | 170% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left | $680.00 | $850.00 | — | 170% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left | $680.00 | $850.00 | — | 170% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right | $680.00 | $850.00 | — | 170% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right | $680.00 | $850.00 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left | $680.00 | $850.00 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right | $680.00 | $850.00 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left | $680.00 | $850.00 | — | — | 20% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral | $581.60 | $727.00 | — | — | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Right | $388.00 | $485.00 | — | 242% above | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left | $388.00 | $485.00 | — | 242% above | 20% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral | $581.60 | $727.00 | — | — | 20% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left | $388.00 | $485.00 | — | — | 20% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Right | $388.00 | $485.00 | — | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left | $392.80 | $491.00 | — | 216% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right | $392.80 | $491.00 | — | 216% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left | $392.80 | $491.00 | — | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right | $392.80 | $491.00 | — | — | 20% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View | $216.80 | $271.00 | — | 79% above | 20% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View | $216.80 | $271.00 | — | — | 20% |
| X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger(s) 2+ Views Bilat | $516.00 | $645.00 | — | — | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Left | $344.80 | $431.00 | — | 236% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Right | $344.80 | $431.00 | — | 236% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Fingers minimum of 2 Views | $344.80 | $431.00 | — | 236% above | 20% |
| X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger(s) 2+ Views Bilat | $516.00 | $645.00 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Fingers minimum of 2 Views | $344.80 | $431.00 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Right | $344.80 | $431.00 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Left | $344.80 | $431.00 | — | — | 20% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete 3+ Views Bilateral | $339.20 | $424.00 | — | — | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Left | $227.20 | $284.00 | — | 90% above | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Right | $227.20 | $284.00 | — | 90% above | 20% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete 3+ Views Bilateral | $339.20 | $424.00 | — | — | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Right | $227.20 | $284.00 | — | — | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Left | $227.20 | $284.00 | — | — | 20% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete 3+ Views Bilateral | $493.60 | $617.00 | — | — | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Right | $330.40 | $413.00 | — | 176% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Left | $330.40 | $413.00 | — | 176% above | 20% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete 3+ Views Bilateral | $493.60 | $617.00 | — | — | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Left | $330.40 | $413.00 | — | — | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Right | $330.40 | $413.00 | — | — | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $409.60 | $512.00 | — | 172% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $409.60 | $512.00 | — | — | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4plus Views | $581.60 | $727.00 | — | 172% above | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4plus Views | $581.60 | $727.00 | — | — | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $323.20 | $404.00 | — | 115% above | 20% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views | $323.20 | $404.00 | — | — | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views | $356.80 | $446.00 | — | 220% above | 20% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views | $356.80 | $446.00 | — | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $388.00 | $485.00 | — | 170% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $388.00 | $485.00 | — | — | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $244.00 | $305.00 | — | 86% above | 20% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $244.00 | $305.00 | — | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views | $298.40 | $373.00 | — | 117% above | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views | $298.40 | $373.00 | — | — | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH, Plasma LC | $876.80 | $1,096.00 | — | 719% above | 20% |
| ACTH blood test inpatient CPT 82024 ACTH, Plasma LC | $876.80 | $1,096.00 | — | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) P5P LC | $116.00 | $145.00 | — | 499% above | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $116.00 | $145.00 | — | 499% above | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) P5P LC | $116.00 | $145.00 | — | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase | $116.00 | $145.00 | — | — | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) P5P LC | $109.60 | $137.00 | — | 471% above | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $109.60 | $137.00 | — | 471% above | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase | $109.60 | $137.00 | — | — | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) P5P LC | $109.60 | $137.00 | — | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel | $1,428.00 | $1,785.00 | — | 1120% above | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis LC | $1,428.00 | $1,785.00 | — | 1120% above | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis LC | $1,428.00 | $1,785.00 | — | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel | $1,428.00 | $1,785.00 | — | — | 20% |
| Albumin blood test CPT 82040 Albumin Level | $73.60 | $92.00 | — | 407% above | 20% |
| Albumin blood test inpatient CPT 82040 Albumin Level | $73.60 | $92.00 | — | — | 20% |
| Aldosterone blood test CPT 82088 Aldosterone LCMS, Serum LC | $883.20 | $1,104.00 | — | 823% above | 20% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone LCMS, Serum LC | $883.20 | $1,104.00 | — | — | 20% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $90.40 | $113.00 | — | 373% above | 20% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phos Isoenzyme LC | $331.20 | $414.00 | — | 1632% above | 20% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $90.40 | $113.00 | — | — | 20% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alk Phos Isoenzyme LC | $331.20 | $414.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Egg White IgE UNMC | $29.60 | $37.00 | — | 185% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F-089-IgE Mustard, LC | $43.68 | $54.60 | — | 320% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Red Snapper LC | $43.68 | $54.60 | — | 320% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Paprika/Sweet Pepper LC | $43.68 | $54.60 | — | 320% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Black Peppercorn LC | $43.68 | $54.60 | — | 320% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F204-IgE Trout LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T218-IgE Oak, Live/Virginia LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G005-IgE Rye Grass Perennial LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W002-IgE Ragweed Western LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M009-IgE Fusarium proliferatum LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W016-IgE Rough Marshelder LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F054-IgE Sweet Potato LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F088-IgE Lamb LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F208-IgE Lemon LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F216-IgE Cabbage LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F320-IgE Crayfish Freshwater LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 C074-IgE Gelatin LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I002-IgE Hornet, White Face LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M010-IgE Stemphylium herbarum LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W004-IgE Ragweed,False LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T037-IgE Bald Cypress LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T057-IgE Cedar Red LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F041-IgE Salmon LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F023-IgE Crab LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G003-IgE Orchard Grass LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F096-IgE Avocado LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F024-IgE Shrimp LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I205-IgE Bumblebee LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F092-IgE Banana LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M016-IgE Curvularia Lunata LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Pineapple LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F083-IgE Chicken LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F095-IgE Peach LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Alpha-Gal IgE Panel LC-86003 | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F047-IgE Garlic LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F017-IgE Hazelnut (Filbert) LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F253-IgE Pine Nut Pignoles LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003-Allergen Profile, Mold LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE, Black Bean LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F091-IgE Mango, LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G012-IgE Rye Grass LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I001-IgE Honeybee LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F027-IgE Beef LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F026-IgE Pork LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgE Egg (Yolk) LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F020-IgE Almond LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F093-IgE Chocolate/Cacao LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F236-IgE Whey LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F044-IgE Strawberry LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F245-IgE Egg, Whole LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F210-IgE Pineapple LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G010-IgE Johnson Grass LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M006-IgE Alternaria alternata LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M002-IgE Cladosporium herbarum LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G002-IgE Bermuda Grass LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D001-IgE D pteronyssinus LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D002-IgE D farinae LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T007-IgE Oak, White LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W014-IgE Pigweed, Common LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M001-IgE Penicillium chrysogen LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W011-IgE Thistle, Russian LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F329-IgE Watermelon LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F018-IgE Brazil Nut LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F084-IgE Kiwi Fruit LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F259-IgE Grape LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T022-IgE Pecan, Hickory LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F080-IgE Lobster LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F345-IgE Macadamia Nut LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F288-IgE Blueberry LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Plantain, English LC 602536 | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Eucalyptus LC 602930 | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F201-IgE Pecan Nut LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F033-IgE Orange LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F010-IgE Sesame Seed LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G008-IgE Bluegrass, Kentucky LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F040-IgE Tuna LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F009-IgE Rice LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F340-IgE Carmine Red Dye LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Milk w/ Component Reflex LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Mold LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Egg White LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Dander LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F025-IgE Tomato LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Aspergillus fumigatus LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I005-IgE Hornet, Yellow LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I004-IgE Paper Wasp LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I003-IgE Yellow Jacket LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F287-IgE Kidney Bean LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Dander LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F008-IgE Corn LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F202-IgE Cashew Nut LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F203-IgE Pistachio Nut LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G006-IgE Timothy Grass LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F256-IgE Walnut LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F220-IgE Cinnamon LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W003-IgE Ragweed, Giant LC | $44.00 | $55.00 | — | 323% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Bing Cherry LC | $46.40 | $58.00 | — | 347% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F049-IgE Apple LC | $46.40 | $58.00 | — | 347% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F094-IgE Pear LC | $46.40 | $58.00 | — | 347% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Class Description LC | $168.00 | $210.00 | — | 1517% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E003-IgE Horse Dander LC | $168.00 | $210.00 | — | 1517% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Stachybotrys atra (Black Mold) LC | $184.80 | $231.00 | — | 1679% above | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White IgE UNMC | $29.60 | $37.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F-089-IgE Mustard, LC | $43.68 | $54.60 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Black Peppercorn LC | $43.68 | $54.60 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Red Snapper LC | $43.68 | $54.60 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Paprika/Sweet Pepper LC | $43.68 | $54.60 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Plantain, English LC 602536 | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I005-IgE Hornet, Yellow LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I004-IgE Paper Wasp LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I003-IgE Yellow Jacket LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I002-IgE Hornet, White Face LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I001-IgE Honeybee LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F027-IgE Beef LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F026-IgE Pork LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F075-IgE Egg (Yolk) LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Aspergillus fumigatus LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F025-IgE Tomato LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E001-IgE Cat Dander LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F001-IgE Egg White LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Mold LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Milk w/ Component Reflex LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F340-IgE Carmine Red Dye LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W003-IgE Ragweed, Giant LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F220-IgE Cinnamon LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F256-IgE Walnut LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G006-IgE Timothy Grass LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F203-IgE Pistachio Nut LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F202-IgE Cashew Nut LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F008-IgE Corn LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Dander LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F287-IgE Kidney Bean LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F091-IgE Mango, LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE, Black Bean LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003-Allergen Profile, Mold LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F253-IgE Pine Nut Pignoles LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F017-IgE Hazelnut (Filbert) LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F047-IgE Garlic LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alpha-Gal IgE Panel LC-86003 | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F095-IgE Peach LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F083-IgE Chicken LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Pineapple LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M016-IgE Curvularia Lunata LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F092-IgE Banana LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I205-IgE Bumblebee LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F024-IgE Shrimp LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F096-IgE Avocado LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G003-IgE Orchard Grass LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F023-IgE Crab LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F041-IgE Salmon LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T057-IgE Cedar Red LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T037-IgE Bald Cypress LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W004-IgE Ragweed,False LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M010-IgE Stemphylium herbarum LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G012-IgE Rye Grass LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C074-IgE Gelatin LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F320-IgE Crayfish Freshwater LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F216-IgE Cabbage LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F208-IgE Lemon LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F088-IgE Lamb LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F054-IgE Sweet Potato LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W016-IgE Rough Marshelder LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M009-IgE Fusarium proliferatum LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W002-IgE Ragweed Western LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G005-IgE Rye Grass Perennial LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T218-IgE Oak, Live/Virginia LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F204-IgE Trout LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F009-IgE Rice LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F040-IgE Tuna LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G008-IgE Bluegrass, Kentucky LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F010-IgE Sesame Seed LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F033-IgE Orange LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F201-IgE Pecan Nut LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Eucalyptus LC 602930 | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F288-IgE Blueberry LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F345-IgE Macadamia Nut LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F080-IgE Lobster LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T022-IgE Pecan, Hickory LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F259-IgE Grape LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F084-IgE Kiwi Fruit LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F018-IgE Brazil Nut LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F329-IgE Watermelon LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W011-IgE Thistle, Russian LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M001-IgE Penicillium chrysogen LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W014-IgE Pigweed, Common LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T007-IgE Oak, White LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D002-IgE D farinae LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D001-IgE D pteronyssinus LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G002-IgE Bermuda Grass LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M002-IgE Cladosporium herbarum LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M006-IgE Alternaria alternata LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G010-IgE Johnson Grass LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F210-IgE Pineapple LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F245-IgE Egg, Whole LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F044-IgE Strawberry LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F236-IgE Whey LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F093-IgE Chocolate/Cacao LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F020-IgE Almond LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk LC | $44.00 | $55.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F094-IgE Pear LC | $46.40 | $58.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F049-IgE Apple LC | $46.40 | $58.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bing Cherry LC | $46.40 | $58.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E003-IgE Horse Dander LC | $168.00 | $210.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Class Description LC | $168.00 | $210.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Stachybotrys atra (Black Mold) LC | $184.80 | $231.00 | — | — | 20% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, Serum, Tumor Marker LC | $177.60 | $222.00 | — | 239% above | 20% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Serum, Tumor Marker LC | $177.60 | $222.00 | — | — | 20% |
| Ammonia blood test CPT 82140 Ammonia LC | $417.60 | $522.00 | — | 744% above | 20% |
| Ammonia blood test inpatient CPT 82140 Ammonia LC | $417.60 | $522.00 | — | — | 20% |
| Amylase blood test CPT 82150 Amylase Level | $162.40 | $203.00 | — | 629% above | 20% |
| Amylase blood test inpatient CPT 82150 Amylase Level | $162.40 | $203.00 | — | — | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC | $248.00 | $310.00 | — | 450% above | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC | $248.00 | $310.00 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive LC | $312.00 | $390.00 | — | 622% above | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies Direct LC | $312.00 | $390.00 | — | 622% above | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies Direct LC | $312.00 | $390.00 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive LC | $312.00 | $390.00 | — | — | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP II | $648.80 | $811.00 | — | 940% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP II | $648.80 | $811.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture MB LC | $248.00 | $310.00 | — | 753% above | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture, Routine MB LC | $248.00 | $310.00 | — | 753% above | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Upper Respiratory Culture MB LC | $254.40 | $318.00 | — | 775% above | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture, Sterile MB LC | $254.40 | $318.00 | — | 775% above | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Gram Stain w/ Sputum Cult Rflx MB LC | $254.40 | $318.00 | — | 775% above | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture, Routine MB LC | $248.00 | $310.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Culture MB LC | $248.00 | $310.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Gram Stain w/ Sputum Cult Rflx MB LC | $254.40 | $318.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Upper Respiratory Culture MB LC | $254.40 | $318.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture, Sterile MB LC | $254.40 | $318.00 | — | — | 20% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $196.00 | $245.00 | — | 489% above | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $196.00 | $245.00 | — | — | 20% |
| Bilirubin blood test, total CPT 82247 Bilirubin Neonatal (Bc/Bu) | $80.80 | $101.00 | — | 391% above | 20% |
| Bilirubin blood test, total CPT 82247 Bilirubin, Ttl LC | $80.80 | $101.00 | — | 391% above | 20% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $84.00 | $105.00 | — | 410% above | 20% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Ttl LC | $80.80 | $101.00 | — | — | 20% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Neonatal (Bc/Bu) | $80.80 | $101.00 | — | — | 20% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $84.00 | $105.00 | — | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HMLA LEVEL 4 SURGICAL PATH GRS/MICRO | $992.80 | $1,241.00 | — | 1115% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HMLA LEVEL 4 SURGICAL PATH GRS/MICRO | $992.80 | $1,241.00 | — | — | 20% |
| Blood culture for bacteria CPT 87040 Blood Culture, Routine LC | $256.80 | $321.00 | — | 494% above | 20% |
| Blood culture for bacteria CPT 87040 Blood Culture MB LC | $256.80 | $321.00 | — | 494% above | 20% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture, Routine LC | $256.80 | $321.00 | — | — | 20% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture MB LC | $256.80 | $321.00 | — | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $19.20 | $24.00 | — | 132% above | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only Venipuncture | $19.20 | $24.00 | — | 132% above | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Only Venipuncture | $19.20 | $24.00 | — | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $19.20 | $24.00 | — | — | 20% |
| Blood glucose (sugar) test CPT 82947 Glucose, S LC | $92.80 | $116.00 | — | 563% above | 20% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting | $93.60 | $117.00 | — | 569% above | 20% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $93.60 | $117.00 | — | 569% above | 20% |
| Blood glucose (sugar) test CPT 82947 Glucose Fingerstick Clinic POC (RE) | $93.60 | $117.00 | — | 569% above | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose, S LC | $92.80 | $116.00 | — | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $93.60 | $117.00 | — | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting | $93.60 | $117.00 | — | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Fingerstick Clinic POC (RE) | $93.60 | $117.00 | — | — | 20% |
| Blood lead test CPT 83655 Lead, Blood (Adult) LC | $317.60 | $397.00 | — | 1027% above | 20% |
| Blood lead test CPT 83655 Lead, Blood (Pediatric) LC | $317.60 | $397.00 | — | 1027% above | 20% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Adult) LC | $317.60 | $397.00 | — | — | 20% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric) LC | $317.60 | $397.00 | — | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum Qual | $212.00 | $265.00 | — | 577% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Serum Qual | $212.00 | $265.00 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill Only ABO Discrepancy Solution | $46.40 | $58.00 | — | 2% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Only | $58.40 | $73.00 | — | 28% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill Only ABO | $58.40 | $73.00 | — | 28% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill Only ABO/Rh | $58.40 | $73.00 | — | 28% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF ABO | $58.40 | $73.00 | — | 28% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF ABO/Rh | $58.40 | $73.00 | — | 28% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill Only ABO Discrepancy Solution | $46.40 | $58.00 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 REF ABO | $58.40 | $73.00 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 REF ABO/Rh | $58.40 | $73.00 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Only | $58.40 | $73.00 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill Only ABO/Rh | $58.40 | $73.00 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill Only ABO | $58.40 | $73.00 | — | — | 20% |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $84.00 | $105.00 | — | 426% above | 20% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen | $84.00 | $105.00 | — | — | 20% |
| C-peptide blood test CPT 84681 C-Peptide, Serum LC | $520.80 | $651.00 | — | 840% above | 20% |
| C-peptide blood test inpatient CPT 84681 C-Peptide, Serum LC | $520.80 | $651.00 | — | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $130.40 | $163.00 | — | 462% above | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $130.40 | $163.00 | — | — | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 LC | $483.20 | $604.00 | — | 891% above | 20% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 LC | $483.20 | $604.00 | — | — | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC | $476.80 | $596.00 | — | 816% above | 20% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC | $476.80 | $596.00 | — | — | 20% |
| Calcium blood test, total CPT 82310 Calcium Level Total | $140.00 | $175.00 | — | 643% above | 20% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Total | $140.00 | $175.00 | — | — | 20% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA LC | $444.00 | $555.00 | — | 653% above | 20% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen | $444.00 | $555.00 | — | 653% above | 20% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen | $444.00 | $555.00 | — | — | 20% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA LC | $444.00 | $555.00 | — | — | 20% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab, IgG LC | $134.40 | $168.00 | — | 258% above | 20% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab, IgM Qualitative LC | $134.40 | $168.00 | — | 258% above | 20% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus (VZV) IgG, Immunity Status LC | $141.60 | $177.00 | — | 277% above | 20% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab, IgM, S LC | $200.00 | $250.00 | — | 433% above | 20% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab, IgM Qualitative LC | $134.40 | $168.00 | — | — | 20% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG LC | $134.40 | $168.00 | — | — | 20% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus (VZV) IgG, Immunity Status LC | $141.60 | $177.00 | — | — | 20% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab, IgM, S LC | $200.00 | $250.00 | — | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia by NAA LC | $324.80 | $406.00 | — | 455% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis, NAA LC | $460.80 | $576.00 | — | 687% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia by NAA LC | $324.80 | $406.00 | — | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis, NAA LC | $460.80 | $576.00 | — | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $170.40 | $213.00 | — | 247% above | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $170.40 | $213.00 | — | — | 20% |
| Complete blood count (CBC), no differential CPT 85027 CBC w/ Manual Differential | $84.00 | $105.00 | — | 202% above | 20% |
| Complete blood count (CBC), no differential CPT 85027 CBC w/ Differential | $143.20 | $179.00 | — | 414% above | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/ Manual Differential | $84.00 | $105.00 | — | — | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/ Differential | $143.20 | $179.00 | — | — | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP | $235.20 | $294.00 | — | 217% above | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP | $235.20 | $294.00 | — | — | 20% |
| Cortisol blood test, total CPT 82533 Cortisol Dexamethasone Reflex LC | $136.00 | $170.00 | — | 255% above | 20% |
| Cortisol blood test, total CPT 82533 Cortisol - AM LC | $207.20 | $259.00 | — | 441% above | 20% |
| Cortisol blood test, total CPT 82533 Cortisol AM | $374.64 | $468.30 | — | 879% above | 20% |
| Cortisol blood test, total CPT 82533 Cortisol Baseline LC | $375.20 | $469.00 | — | 880% above | 20% |
| Cortisol blood test, total CPT 82533 Cortisol LC | $375.20 | $469.00 | — | 880% above | 20% |
| Cortisol blood test, total CPT 82533 Cortisol Stimulated LC | $375.20 | $469.00 | — | 880% above | 20% |
| Cortisol blood test, total CPT 82533 Cortisol | $384.00 | $480.00 | — | 903% above | 20% |
| Cortisol blood test, total CPT 82533 .Cortisol Baseline | $393.60 | $492.00 | — | 928% above | 20% |
| Cortisol blood test, total CPT 82533 Cortisol PM | $393.60 | $492.00 | — | 928% above | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Dexamethasone Reflex LC | $136.00 | $170.00 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol - AM LC | $207.20 | $259.00 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol AM | $374.64 | $468.30 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Stimulated LC | $375.20 | $469.00 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol LC | $375.20 | $469.00 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Baseline LC | $375.20 | $469.00 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol | $384.00 | $480.00 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol Baseline | $393.60 | $492.00 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol PM | $393.60 | $492.00 | — | — | 20% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $150.40 | $188.00 | — | 577% above | 20% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $150.40 | $188.00 | — | — | 20% |
| Creatinine blood test CPT 82565 Creatinine | $103.20 | $129.00 | — | 490% above | 20% |
| Creatinine blood test inpatient CPT 82565 Creatinine | $103.20 | $129.00 | — | — | 20% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC | $308.00 | $385.00 | — | 732% above | 20% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC | $308.00 | $385.00 | — | — | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer | $278.40 | $348.00 | — | 468% above | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer | $278.40 | $348.00 | — | — | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate LC | $534.40 | $668.00 | — | 829% above | 20% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate LC | $534.40 | $668.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen- Collection Only DOT | $47.20 | $59.00 | — | 65% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Bill Only Drug Screen Collection | $151.20 | $189.00 | — | 429% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl Urine LC | $324.80 | $406.00 | — | 1036% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Synthetic Cannabinoids, U LC | $324.80 | $406.00 | — | 1036% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 8 w/Conf, WB LC | $408.80 | $511.00 | — | 1329% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone/Oxymorphone Ur LC | $408.80 | $511.00 | — | 1329% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Profile, Ur, 9 Drugs LC | $455.20 | $569.00 | — | 1492% above | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen- Collection Only DOT | $47.20 | $59.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Bill Only Drug Screen Collection | $151.20 | $189.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Synthetic Cannabinoids, U LC | $324.80 | $406.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl Urine LC | $324.80 | $406.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone/Oxymorphone Ur LC | $408.80 | $511.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 8 w/Conf, WB LC | $408.80 | $511.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Profile, Ur, 9 Drugs LC | $455.20 | $569.00 | — | — | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Lytes | $152.80 | $191.00 | — | 313% above | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Lytes | $152.80 | $191.00 | — | — | 20% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Ab VCA, IgG LC | $371.20 | $464.00 | — | 627% above | 20% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Ab VCA, IgM LC | $371.20 | $464.00 | — | 627% above | 20% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Ab VCA, IgG LC | $371.20 | $464.00 | — | — | 20% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Ab VCA, IgM LC | $371.20 | $464.00 | — | — | 20% |
| Estradiol blood test CPT 82670 Estradiol, Sensitive LC | $264.80 | $331.00 | — | 364% above | 20% |
| Estradiol blood test CPT 82670 Estradiol Level | $623.20 | $779.00 | — | 992% above | 20% |
| Estradiol blood test inpatient CPT 82670 Estradiol, Sensitive LC | $264.80 | $331.00 | — | — | 20% |
| Estradiol blood test inpatient CPT 82670 Estradiol Level | $623.20 | $779.00 | — | — | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Level | $417.60 | $522.00 | — | 643% above | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Level | $417.60 | $522.00 | — | — | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal LC | $338.40 | $423.00 | — | 240% above | 20% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal LC | $338.40 | $423.00 | — | — | 20% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $376.80 | $471.00 | — | 719% above | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $376.80 | $471.00 | — | — | 20% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $331.20 | $414.00 | — | 740% above | 20% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $331.20 | $414.00 | — | — | 20% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine (T3), Free LC | $512.80 | $641.00 | — | 1095% above | 20% |
| Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine (T3), Free LC | $512.80 | $641.00 | — | — | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $162.40 | $203.00 | — | 366% above | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 by Dialysis/Mass Spec LC | $512.00 | $640.00 | — | 1370% above | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level | $162.40 | $203.00 | — | — | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 by Dialysis/Mass Spec LC | $512.00 | $640.00 | — | — | 20% |
| Free testosterone test CPT 84402 Testosterone, Free, Direct LC | $532.80 | $666.00 | — | 772% above | 20% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct LC | $532.80 | $666.00 | — | — | 20% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $113.60 | $142.00 | — | 357% above | 20% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT LC | $120.00 | $150.00 | — | 383% above | 20% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase | $113.60 | $142.00 | — | — | 20% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT LC | $120.00 | $150.00 | — | — | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $168.00 | $210.00 | — | 13% below | 20% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $168.00 | $210.00 | — | — | 20% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose 1 Hour | $280.80 | $351.00 | — | 529% above | 20% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT 3 HR | $292.80 | $366.00 | — | 555% above | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose 1 Hour | $280.80 | $351.00 | — | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT 3 HR | $292.80 | $366.00 | — | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus by NAA LC | $323.20 | $404.00 | — | 452% above | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae, NAA LC | $323.20 | $404.00 | — | 452% above | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae, NAA LC | $323.20 | $404.00 | — | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonococcus by NAA LC | $323.20 | $404.00 | — | — | 20% |
| H. pylori stool antigen test CPT 87338 H. pylori Stool Ag, EIA LC | $312.00 | $390.00 | — | 407% above | 20% |
| H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool Ag, EIA LC | $312.00 | $390.00 | — | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RealTime Abbott LC | $739.20 | $924.00 | — | 329% above | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 Human Immunodeficiency Virus 1, Quant, RT PCR (Graph) LC | $1,730.40 | $2,163.00 | — | 905% above | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RealTime Abbott LC | $739.20 | $924.00 | — | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 Human Immunodeficiency Virus 1, Quant, RT PCR (Graph) LC | $1,730.40 | $2,163.00 | — | — | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab w/ Reflex to Conf LC | $281.60 | $352.00 | — | 485% above | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab w/ Reflex to Conf LC | $281.60 | $352.00 | — | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c w/eAG | $239.20 | $299.00 | — | 629% above | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $239.20 | $299.00 | — | 629% above | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c | $239.20 | $299.00 | — | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c w/eAG | $239.20 | $299.00 | — | — | 20% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $64.80 | $81.00 | — | 522% above | 20% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $64.80 | $81.00 | — | — | 20% |
| Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab, Tot LC | $275.20 | $344.00 | — | 854% above | 20% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab, Tot LC | $275.20 | $344.00 | — | — | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab, Qual. LC | $236.80 | $296.00 | — | 726% above | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab, Qual. LC | $236.80 | $296.00 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen LC | $232.00 | $290.00 | — | 532% above | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBsAg Screen LC | $232.00 | $290.00 | — | — | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 Anti-Hepatitis B core Total | $132.80 | $166.00 | — | 186% above | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody RFX to Quant PCR LC | $307.20 | $384.00 | — | 561% above | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody LC | $307.20 | $384.00 | — | 561% above | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Anti-Hepatitis B core Total | $132.80 | $166.00 | — | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody LC | $307.20 | $384.00 | — | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody RFX to Quant PCR LC | $307.20 | $384.00 | — | — | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA by PCR, Qn Rfx Geno GRAPH LC | $1,296.00 | $1,620.00 | — | 1005% above | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA Diagnosis, NAA LC | $1,296.00 | $1,620.00 | — | 1005% above | 20% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) LC | $1,296.00 | $1,620.00 | — | 1005% above | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA by PCR, Qn Rfx Geno GRAPH LC | $1,296.00 | $1,620.00 | — | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA Diagnosis, NAA LC | $1,296.00 | $1,620.00 | — | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) LC | $1,296.00 | $1,620.00 | — | — | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV type 1-Specific Ab, IgG LC | $317.60 | $397.00 | — | 1115% above | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV type 1-Specific Ab, IgG LC | $317.60 | $397.00 | — | — | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 Ab IgG LC | $424.80 | $531.00 | — | 860% above | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 Ab IgG LC | $424.80 | $531.00 | — | — | 20% |
| Homocysteine blood test CPT 83090 Homocyst(e)ine LC | $695.20 | $869.00 | — | 1117% above | 20% |
| Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine LC | $695.20 | $869.00 | — | — | 20% |
| Insulin blood test CPT 83525 Insulin LC | $254.40 | $318.00 | — | 671% above | 20% |
| Insulin blood test CPT 83525 Free and Total Insulin LC | $254.40 | $318.00 | — | 671% above | 20% |
| Insulin blood test inpatient CPT 83525 Free and Total Insulin LC | $254.40 | $318.00 | — | — | 20% |
| Insulin blood test inpatient CPT 83525 Insulin LC | $254.40 | $318.00 | — | — | 20% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $162.40 | $203.00 | — | 652% above | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $162.40 | $203.00 | — | — | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 Direct TIBC | $228.80 | $286.00 | — | 611% above | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 direct Total Iron Binding Capacity | $228.80 | $286.00 | — | 611% above | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Level and dTIBC | $228.80 | $286.00 | — | 611% above | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 direct Total Iron Binding Capacity | $228.80 | $286.00 | — | — | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Level and dTIBC | $228.80 | $286.00 | — | — | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Direct TIBC | $228.80 | $286.00 | — | — | 20% |
| Kidney function blood test panel CPT 80069 Renal Pnl | $189.60 | $237.00 | — | 247% above | 20% |
| Kidney function blood test panel inpatient CPT 80069 Renal Pnl | $189.60 | $237.00 | — | — | 20% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $420.00 | $525.00 | — | 677% above | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone | $420.00 | $525.00 | — | — | 20% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $360.00 | $450.00 | — | 1188% above | 20% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $360.00 | $450.00 | — | — | 20% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD, Body Fluid LC | $109.60 | $137.00 | — | 426% above | 20% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $110.40 | $138.00 | — | 430% above | 20% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD, Body Fluid LC | $109.60 | $137.00 | — | — | 20% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $110.40 | $138.00 | — | — | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $110.40 | $138.00 | — | 341% above | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $110.40 | $138.00 | — | — | 20% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $182.40 | $228.00 | — | 256% above | 20% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $182.40 | $228.00 | — | — | 20% |
| Lyme disease antibody test CPT 86618 Lyme IgG LC | $447.20 | $559.00 | — | 783% above | 20% |
| Lyme disease antibody test CPT 86618 Lyme Interpretation LC | $447.20 | $559.00 | — | 783% above | 20% |
| Lyme disease antibody test CPT 86618 Lyme IgM LC | $447.20 | $559.00 | — | 783% above | 20% |
| Lyme disease antibody test CPT 86618 Lyme Disease Serology w/Reflex LC | $447.20 | $559.00 | — | 783% above | 20% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Interpretation LC | $447.20 | $559.00 | — | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 Lyme IgG LC | $447.20 | $559.00 | — | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Serology w/Reflex LC | $447.20 | $559.00 | — | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 Lyme IgM LC | $447.20 | $559.00 | — | — | 20% |
| Magnesium blood test CPT 83735 Magnesium Level | $162.40 | $203.00 | — | 635% above | 20% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $162.40 | $203.00 | — | — | 20% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Ab, IgG LC | $258.40 | $323.00 | — | 736% above | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Ab, IgG LC | $258.40 | $323.00 | — | — | 20% |
| Mumps immunity blood test CPT 86735 Mumps Abs, IgG LC | $275.20 | $344.00 | — | 806% above | 20% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Abs, IgG LC | $275.20 | $344.00 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Free LC | $195.20 | $244.00 | — | 301% above | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Free LC | $195.20 | $244.00 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen | $107.20 | $134.00 | — | 141% above | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag LC | $195.20 | $244.00 | — | 339% above | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic | $195.20 | $244.00 | — | 339% above | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen | $107.20 | $134.00 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag LC | $195.20 | $244.00 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic | $195.20 | $244.00 | — | — | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath Screen GYN | $308.00 | $385.00 | — | 613% above | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Cytology Gyn Consultation DP | $308.00 | $385.00 | — | 613% above | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath Screen | $308.00 | $385.00 | — | 613% above | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytology Gyn Consultation DP | $308.00 | $385.00 | — | — | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath Screen GYN | $308.00 | $385.00 | — | — | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath Screen | $308.00 | $385.00 | — | — | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC | $929.60 | $1,162.00 | — | 917% above | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact LC | $929.60 | $1,162.00 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $160.80 | $201.00 | — | 675% above | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT, Activated | $160.80 | $201.00 | — | 675% above | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT, Activated | $160.80 | $201.00 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $160.80 | $201.00 | — | — | 20% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $113.60 | $142.00 | — | 595% above | 20% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $113.60 | $142.00 | — | — | 20% |
| Potassium blood test CPT 84132 Potassium Level | $107.20 | $134.00 | — | 534% above | 20% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $107.20 | $134.00 | — | — | 20% |
| Progesterone blood test CPT 84144 Progesterone Level | $391.20 | $489.00 | — | 604% above | 20% |
| Progesterone blood test inpatient CPT 84144 Progesterone Level | $391.20 | $489.00 | — | — | 20% |
| Prolactin blood test CPT 84146 Prolactin LC | $403.20 | $504.00 | — | 523% above | 20% |
| Prolactin blood test inpatient CPT 84146 Prolactin LC | $403.20 | $504.00 | — | — | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT (INR) | $117.60 | $147.00 | — | 713% above | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR | $117.60 | $147.00 | — | 713% above | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $117.60 | $147.00 | — | 713% above | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 International Normalization Ratio | $117.60 | $147.00 | — | 713% above | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR | $117.60 | $147.00 | — | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $117.60 | $147.00 | — | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 International Normalization Ratio | $117.60 | $147.00 | — | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT (INR) | $117.60 | $147.00 | — | — | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen Clinic POC (RE) | $72.00 | $90.00 | — | 211% above | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Urine Drug Screen Clinic POC (RE) | $72.00 | $90.00 | — | — | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Clinic POC (RE) | $78.40 | $98.00 | — | 220% above | 20% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep Clinic POC (RE) | $78.40 | $98.00 | — | — | 20% |
| Renin blood test CPT 84244 Renin Activity, Plasma LC | $551.20 | $689.00 | — | 818% above | 20% |
| Renin blood test inpatient CPT 84244 Renin Activity, Plasma LC | $551.20 | $689.00 | — | — | 20% |
| Rh blood typing CPT 86901 REF Rh | $63.20 | $79.00 | — | 198% above | 20% |
| Rh blood typing CPT 86901 Rh Only | $63.20 | $79.00 | — | 198% above | 20% |
| Rh blood typing CPT 86901 RH Add-On | $63.20 | $79.00 | — | 198% above | 20% |
| Rh blood typing inpatient CPT 86901 RH Add-On | $63.20 | $79.00 | — | — | 20% |
| Rh blood typing inpatient CPT 86901 REF Rh | $63.20 | $79.00 | — | — | 20% |
| Rh blood typing inpatient CPT 86901 Rh Only | $63.20 | $79.00 | — | — | 20% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC | $298.40 | $373.00 | — | 792% above | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgG LC | $298.40 | $373.00 | — | — | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate (ESR) LC | $116.00 | $145.00 | — | 532% above | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate (ESR) LC | $116.00 | $145.00 | — | — | 20% |
| Sodium blood test CPT 84295 Sodium Level | $84.00 | $105.00 | — | 392% above | 20% |
| Sodium blood test inpatient CPT 84295 Sodium Level | $84.00 | $105.00 | — | — | 20% |
| Stool ova and parasites exam CPT 87177 Ova + Parasite Status LC | $189.60 | $237.00 | — | 528% above | 20% |
| Stool ova and parasites exam CPT 87177 Ova and Parasites MB LC | $189.60 | $237.00 | — | 528% above | 20% |
| Stool ova and parasites exam inpatient CPT 87177 Ova + Parasite Status LC | $189.60 | $237.00 | — | — | 20% |
| Stool ova and parasites exam inpatient CPT 87177 Ova and Parasites MB LC | $189.60 | $237.00 | — | — | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 ColoFIT, Occult Blood, Fecal, IA LC | $260.00 | $325.00 | — | 969% above | 20% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ColoFIT, Occult Blood, Fecal, IA LC | $260.00 | $325.00 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponemal Antibodies, TPPA LC | $126.40 | $158.00 | — | 372% above | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Ab (FTA-Ab) LC | $292.80 | $366.00 | — | 993% above | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponemal Antibodies, TPPA LC | $126.40 | $158.00 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Ab (FTA-Ab) LC | $292.80 | $366.00 | — | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qualitative | $130.40 | $163.00 | — | 912% above | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Sexually Transmitted Infections Profile, LC | $336.00 | $420.00 | — | 2509% above | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qualitative | $130.40 | $163.00 | — | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Sexually Transmitted Infections Profile, LC | $336.00 | $420.00 | — | — | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus LC | $985.60 | $1,232.00 | — | 735% above | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus LC | $985.60 | $1,232.00 | — | — | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level Total | $592.80 | $741.00 | — | 894% above | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Level Total | $592.80 | $741.00 | — | — | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab LC | $344.80 | $431.00 | — | 819% above | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 TPO Ab LC | $350.40 | $438.00 | — | 834% above | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC | $350.40 | $438.00 | — | 834% above | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab LC | $344.80 | $431.00 | — | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO Ab LC | $350.40 | $438.00 | — | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC | $350.40 | $438.00 | — | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $176.00 | $220.00 | — | 337% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $176.00 | $220.00 | — | — | 20% |
| Total IgE blood test CPT 82785 Alpha-Gal IgE Panel LC | $334.40 | $418.00 | — | 769% above | 20% |
| Total IgE blood test CPT 82785 Immunoglobulin E, Total LC | $334.40 | $418.00 | — | 769% above | 20% |
| Total IgE blood test CPT 82785 Allergens w/Comp Rflx Area 6 LC | $902.40 | $1,128.00 | — | 2244% above | 20% |
| Total IgE blood test CPT 82785 Allergen Profile, Pediatric LC | $985.60 | $1,232.00 | — | 2460% above | 20% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E, Total LC | $334.40 | $418.00 | — | — | 20% |
| Total IgE blood test inpatient CPT 82785 Alpha-Gal IgE Panel LC | $334.40 | $418.00 | — | — | 20% |
| Total IgE blood test inpatient CPT 82785 Allergens w/Comp Rflx Area 6 LC | $902.40 | $1,128.00 | — | — | 20% |
| Total IgE blood test inpatient CPT 82785 Allergen Profile, Pediatric LC | $985.60 | $1,232.00 | — | — | 20% |
| Total cholesterol blood test CPT 82465 Cholesterol Total LC | $90.40 | $113.00 | — | 503% above | 20% |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $90.40 | $113.00 | — | 503% above | 20% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total LC | $90.40 | $113.00 | — | — | 20% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total | $90.40 | $113.00 | — | — | 20% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4) LC | $162.40 | $203.00 | — | 594% above | 20% |
| Total thyroxine (T4) blood test CPT 84436 Total T4 Level | $162.40 | $203.00 | — | 594% above | 20% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (T4) LC | $162.40 | $203.00 | — | — | 20% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Total T4 Level | $162.40 | $203.00 | — | — | 20% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) LC | $374.40 | $468.00 | — | 744% above | 20% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) LC | $374.40 | $468.00 | — | — | 20% |
| Transferrin blood test CPT 84466 Transferrin | $322.40 | $403.00 | — | 705% above | 20% |
| Transferrin blood test inpatient CPT 84466 Transferrin | $322.40 | $403.00 | — | — | 20% |
| Trichomonas test (NAAT) CPT 87661 Trich Vag by NAA LC | $323.20 | $404.00 | — | 519% above | 20% |
| Trichomonas test (NAAT) CPT 87661 Trich vag by NAA LC | $522.40 | $653.00 | — | 900% above | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trich Vag by NAA LC | $323.20 | $404.00 | — | — | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trich vag by NAA LC | $522.40 | $653.00 | — | — | 20% |
| Triglycerides blood test CPT 84478 Triglycerides LC | $109.60 | $137.00 | — | 360% above | 20% |
| Triglycerides blood test CPT 84478 Triglycerides | $109.60 | $137.00 | — | 360% above | 20% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides LC | $109.60 | $137.00 | — | — | 20% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $109.60 | $137.00 | — | — | 20% |
| Troponin test, quantitative CPT 84484 Troponin-I | $278.40 | $348.00 | — | 631% above | 20% |
| Troponin test, quantitative inpatient CPT 84484 Troponin-I | $278.40 | $348.00 | — | — | 20% |
| Uric acid blood test CPT 84550 Uric Acid | $109.60 | $137.00 | — | 559% above | 20% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $109.60 | $137.00 | — | — | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Protein,Ttl,U LC | $72.80 | $91.00 | — | 207% above | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Microscopic | $105.60 | $132.00 | — | 346% above | 20% |
| Urinalysis with microscope exam, automated CPT 81001 UA w Micro | $105.60 | $132.00 | — | 346% above | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Protein,Ttl,U LC | $72.80 | $91.00 | — | — | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA w Micro | $105.60 | $132.00 | — | — | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Microscopic | $105.60 | $132.00 | — | — | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick | $84.00 | $105.00 | — | 868% above | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick | $84.00 | $105.00 | — | — | 20% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis W/O Microscopy Clinic POC (RE) | $48.80 | $61.00 | — | 607% above | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis W/O Microscopy Clinic POC (RE) | $48.80 | $61.00 | — | — | 20% |
| Urine microalbumin (albumin) test CPT 82043 Albumin, U LC | $235.20 | $294.00 | — | 1106% above | 20% |
| Urine microalbumin (albumin) test CPT 82043 Albumin, U24 LC | $235.20 | $294.00 | — | 1106% above | 20% |
| Urine microalbumin (albumin) test CPT 82043 Albumin, Random Urine LC | $235.20 | $294.00 | — | 1106% above | 20% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin, U24 LC | $235.20 | $294.00 | — | — | 20% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin, Random Urine LC | $235.20 | $294.00 | — | — | 20% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin, U LC | $235.20 | $294.00 | — | — | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $365.60 | $457.00 | — | 817% above | 20% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $365.60 | $457.00 | — | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $901.60 | $1,127.00 | — | 1071% above | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level | $901.60 | $1,127.00 | — | — | 20% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol(1,25 di-OH Vit D) LC | $778.40 | $973.00 | — | 662% above | 20% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol(1,25 di-OH Vit D) LC | $778.40 | $973.00 | — | — | 20% |
| Zinc blood test CPT 84630 Zinc, Plasma or Serum LC | $96.80 | $121.00 | — | 188% above | 20% |
| Zinc blood test inpatient CPT 84630 Zinc, Plasma or Serum LC | $96.80 | $121.00 | — | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative | $388.00 | $485.00 | — | 664% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG, Beta Subunit, Qn (Serial) LC | $404.80 | $506.00 | — | 697% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Quantitative | $388.00 | $485.00 | — | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG, Beta Subunit, Qn (Serial) LC | $404.80 | $506.00 | — | — | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 42830 Adenoidectomy, primary; younger than age 12 | $1,075.20 | $1,344.00 | — | 70% below | 20% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 42830 Adenoidectomy, primary; younger than age 12 | $1,075.20 | $1,344.00 | — | — | 20% |
| Appendectomy, open surgery CPT 44950 44950 Appendectomy; | $2,658.40 | $3,323.00 | — | 56% above | 20% |
| Appendectomy, open surgery inpatient CPT 44950 44950 Appendectomy; | $2,658.40 | $3,323.00 | — | — | 20% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 29827 Arthroscopy, shoulder, surgical; with rotator cuff repair | $4,925.60 | $6,157.00 | — | 51% below | 20% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 29827 Arthroscopy, shoulder, surgical; with rotator cuff repair | $4,925.60 | $6,157.00 | — | — | 20% |
| Botox injections for chronic migraine both sides CPT 64615 64615 Chemodenervation of muscle(s); muscle(s) innervated nerves, bilateral | $722.40 | $903.00 | — | — | 20% |
| Botox injections for chronic migraine CPT 64615 64615 BOTOX FOR MIGRAINE | $1,295.20 | $1,619.00 | — | 706% above | 20% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 64615 Chemodenervation of muscle(s); muscle(s) innervated nerves, bilateral | $722.40 | $903.00 | — | — | 20% |
| Botox injections for chronic migraine inpatient CPT 64615 64615 BOTOX FOR MIGRAINE | $1,295.20 | $1,619.00 | — | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 Closed treatment of metatarsal fracture; without manipulation, each | $741.60 | $927.00 | — | 281% above | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470 Closed treatment of metatarsal fracture; without manipulation, each | $741.60 | $927.00 | — | — | 20% |
| Bunion correction with removal of part of the big toe joint CPT 28292 28292 Correction, hallux valgus (bunion), w/ or w/o sesamoidectomy; Keller, Mayo type procedure | $2,370.40 | $2,963.00 | — | 20% below | 20% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 28292 Correction, hallux valgus (bunion), w/ or w/o sesamoidectomy; Keller, Mayo type procedure | $2,370.40 | $2,963.00 | — | — | 20% |
| Cardiac catheterization with coronary angiogram CPT 93458 93458 Cath placement w/ injection(s) for coronary angiography; L heart cath for L ventriculography | $2,152.00 | $2,690.00 | — | 54% below | 20% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 93458 Cath placement w/ injection(s) for coronary angiography; L heart cath for L ventriculography | $2,152.00 | $2,690.00 | — | — | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 - Cardioversion; Elective | $1,095.20 | $1,369.00 | — | 88% above | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 - Cardioversion; Elective | $1,095.20 | $1,369.00 | — | — | 20% |
| Carpal tunnel release, open surgery CPT 64721 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel | $1,829.60 | $2,287.00 | — | 4% above | 20% |
| Carpal tunnel release, open surgery inpatient CPT 64721 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel | $1,829.60 | $2,287.00 | — | — | 20% |
| Cervical biopsy CPT 57500 57500 Biopsy of cervix, single or multiple, or local excision of lesion, w/ or w/o fulguration | $424.00 | $530.00 | — | 16% below | 20% |
| Cervical biopsy inpatient CPT 57500 57500 Biopsy of cervix, single or multiple, or local excision of lesion, w/ or w/o fulguration | $424.00 | $530.00 | — | — | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 54150 Excision Procedures on the Penis | $655.20 | $819.00 | — | 45% below | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 54150 Circumcision, using clamp or other device with regional dorsal penile or ring block | $671.20 | $839.00 | — | 43% below | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 54150 Excision Procedures on the Penis | $655.20 | $819.00 | — | — | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 54150 Circumcision, using clamp or other device with regional dorsal penile or ring block | $671.20 | $839.00 | — | — | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 57454 Colposcopy of the cervix incl. vagina w/ biopsy of cervix and endocervical curettage | $547.20 | $684.00 | — | 113% above | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 57454 Colposcopy of the cervix incl. vagina w/ biopsy of cervix and endocervical curettage | $547.20 | $684.00 | — | — | 20% |
| Coronary stent placement, one artery CPT 92928 92928 Stent(s) placement, w/ angioplasty when performed; single major coronary artery or branch | $3,463.20 | $4,329.00 | — | 57% below | 20% |
| Coronary stent placement, one artery inpatient CPT 92928 92928 Stent(s) placement, w/ angioplasty when performed; single major coronary artery or branch | $3,463.20 | $4,329.00 | — | — | 20% |
| Cystoscopy with ureteral stent placement CPT 52332 52332 Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) | $648.80 | $811.00 | — | 67% below | 20% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 52332 Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) | $648.80 | $811.00 | — | — | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000 Cystourethroscopy (separate procedure) | $526.40 | $658.00 | — | 17% below | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000 CYSTOSCOPY | $1,943.20 | $2,429.00 | — | 206% above | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 52000 Cystourethroscopy (separate procedure) | $526.40 | $658.00 | — | — | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 52000 CYSTOSCOPY | $1,943.20 | $2,429.00 | — | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettemen | $113.60 | $142.00 | — | 17% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000-Destruction Premalignant Lesions | $588.00 | $735.00 | — | 504% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettemen | $113.60 | $142.00 | — | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 17000-Destruction Premalignant Lesions | $588.00 | $735.00 | — | — | 20% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $1,030.40 | $1,288.00 | — | 30% below | 20% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $1,030.40 | $1,288.00 | — | — | 20% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 69433 Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia | $632.00 | $790.00 | — | 27% above | 20% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 69433 Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia | $632.00 | $790.00 | — | — | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Irrigation POC | $54.40 | $68.00 | — | 22% below | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE | $63.20 | $79.00 | — | 10% below | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-Cerumen Irrigation/Lavage | $294.40 | $368.00 | — | 320% above | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ear Irrigation POC | $54.40 | $68.00 | — | — | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE | $63.20 | $79.00 | — | — | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-Cerumen Irrigation/Lavage | $294.40 | $368.00 | — | — | 20% |
| Earwax removal with instruments, one ear CPT 69210 69210-Cerumen w/ Instrumentation | $136.00 | $170.00 | — | 121% above | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 Removal impacted cerumen requiring instrumentation, unilateral. | $126.40 | $158.00 | — | 105% above | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 Removal impacted cerumen requiring instrumentation, LT | $140.00 | $175.00 | — | 127% above | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 Removal impacted cerumen requiring instrumentation, RT | $140.00 | $175.00 | — | 127% above | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210-Cerumen w/ Instrumentation | $136.00 | $170.00 | — | — | 20% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 69210 Removal impacted cerumen requiring instrumentation, unilateral. | $126.40 | $158.00 | — | — | 20% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 69210 Removal impacted cerumen requiring instrumentation, LT | $140.00 | $175.00 | — | — | 20% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 69210 Removal impacted cerumen requiring instrumentation, RT | $140.00 | $175.00 | — | — | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 Endometrial biopsy with or w/o endocer biopsy, w/o cervical dilation, any method | $180.80 | $226.00 | — | 16% above | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERVICAL SAMPLING (BIOPSY), WITHOUT ProFee | $189.60 | $237.00 | — | 22% above | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 58100 Endometrial biopsy with or w/o endocer biopsy, w/o cervical dilation, any method | $180.80 | $226.00 | — | — | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 58100 ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERVICAL SAMPLING (BIOPSY), WITHOUT ProFee | $189.60 | $237.00 | — | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321 ESI cervical or thoracic with fluoroscopy | $485.60 | $607.00 | — | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 62321 ESI cervical or thoracic with fluoroscopy | $485.60 | $607.00 | — | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493 Injection Paravertebral Facet Joint - single level | $750.40 | $938.00 | — | 10% above | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493 Injection Paravertebral Facet Joint - single level | $750.40 | $938.00 | — | — | 20% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 49593 RPR AA HRN 1ST 3-10 RDC | $5,453.60 | $6,817.00 | — | 7% below | 20% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 49593 RPR AA HRN 1ST 3-10 RDC | $5,453.60 | $6,817.00 | — | — | 20% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 49591 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigel | $5,453.60 | $6,817.00 | — | 33% above | 20% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 49591 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigel | $5,453.60 | $6,817.00 | — | — | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 Sigmoidoscopy, flexible; dx, with or without collection of specimen(s) by brushing or washing | $135.20 | $169.00 | — | 73% below | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 45330 Sigmoidoscopy, flexible; dx, with or without collection of specimen(s) by brushing or washing | $135.20 | $169.00 | — | — | 20% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 47563 Lap, cholecystectomy w/ cholangiography | $3,141.60 | $3,927.00 | — | 11% below | 20% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 47563 Lap, cholecystectomy w/ cholangiography | $3,141.60 | $3,927.00 | — | — | 20% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 46221 Hemorrhoidectomy, internal, by rubber band ligation(s) | $588.00 | $735.00 | — | 28% above | 20% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 46221 Hemorrhoidectomy, internal, by rubber band ligation(s) | $588.00 | $735.00 | — | — | 20% |
| Hysteroscopy with endometrial ablation CPT 58563 58563 Hysteroscopy, surgical; with endometrial ablation | $2,476.80 | $3,096.00 | — | 12% below | 20% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 58563 Hysteroscopy, surgical; with endometrial ablation | $2,476.80 | $3,096.00 | — | — | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple | $588.00 | $735.00 | — | 192% above | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 I & D ABSCESS SIMPLE CHARGE | $756.00 | $945.00 | — | 275% above | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple | $588.00 | $735.00 | — | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 I & D ABSCESS SIMPLE CHARGE | $756.00 | $945.00 | — | — | 20% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 Repair initial inguinal hernia, age 5 years or older; reducible | $2,171.20 | $2,714.00 | — | 29% below | 20% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505 Repair initial inguinal hernia, age 5 years or older; reducible | $2,171.20 | $2,714.00 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 SNF PF DRAIN/INJ JOINT/BURSE W/O US-HMC | $211.20 | $264.00 | — | 18% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis aspiration and/or injection major joint or bursa without ultrasound guidance | $254.40 | $318.00 | — | 2% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 INJ/DRAIN MAJ JT CHARGE | $588.00 | $735.00 | — | 128% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US | $588.00 | $735.00 | — | 128% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 SNF PF DRAIN/INJ JOINT/BURSE W/O US-HMC | $211.20 | $264.00 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Arthrocentesis aspiration and/or injection major joint or bursa without ultrasound guidance | $254.40 | $318.00 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Major Joint Aspirate/Inject w/o US | $588.00 | $735.00 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 INJ/DRAIN MAJ JT CHARGE | $588.00 | $735.00 | — | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-Intermediate Aspiration/Inj w/o US | $588.00 | $735.00 | — | 137% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Intermediate Jt/Bursa Injection Charge | $588.00 | $735.00 | — | 137% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 Intermediate Jt/Bursa Injection Charge | $588.00 | $735.00 | — | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-Intermediate Aspiration/Inj w/o US | $588.00 | $735.00 | — | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600-Small Joint Aspirate/Inject w/o US | $588.00 | $735.00 | — | 128% above | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600-Small Joint Aspirate/Inject w/o US | $588.00 | $735.00 | — | — | 20% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 29882 Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) | $3,864.00 | $4,830.00 | — | 50% below | 20% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 29882 Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) | $3,864.00 | $4,830.00 | — | — | 20% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 49650 Laparoscopy, surgical; repair initial inguinal hernia | $2,288.80 | $2,861.00 | — | 49% below | 20% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 49650 Laparoscopy, surgical; repair initial inguinal hernia | $2,288.80 | $2,861.00 | — | — | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 YAG LASER CHARGE | $1,943.20 | $2,429.00 | — | 324% above | 20% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 YAG LASER CHARGE | $1,943.20 | $2,429.00 | — | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair, intermediate; wounds of scalp, axillae, trunk, extremities; <2.5cm | $438.40 | $548.00 | — | 36% above | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm | $588.00 | $735.00 | — | 82% above | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 Repair, intermediate; wounds of scalp, axillae, trunk, extremities; <2.5cm | $438.40 | $548.00 | — | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm | $588.00 | $735.00 | — | — | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323 ESI lumbar or sacral with fluoroscopy | $419.20 | $524.00 | — | 41% below | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 ESI lumbar or sacral with fluoroscopy | $419.20 | $524.00 | — | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 Excision, benign lesion including margins; trunk, arms or legs; < 0.5cm | $155.20 | $194.00 | — | 59% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400 Excision, benign lesion including margins; trunk, arms or legs; < 0.5cm | $155.20 | $194.00 | — | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm | $651.20 | $814.00 | — | 72% above | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal | $651.20 | $814.00 | — | 72% above | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm | $651.20 | $814.00 | — | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal | $651.20 | $814.00 | — | — | 20% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion of nail plate, partial or complete, simple; single | $178.40 | $223.00 | — | 26% above | 20% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion of nail plate, partial or complete, simple; 1 nail plate | $304.80 | $381.00 | — | 115% above | 20% |
| Nail removal (partial or complete), one nail CPT 11730 11730-Avulsion Nail Plate Single | $1,644.80 | $2,056.00 | — | 1061% above | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion of nail plate, partial or complete, simple; single | $178.40 | $223.00 | — | — | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion of nail plate, partial or complete, simple; 1 nail plate | $304.80 | $381.00 | — | — | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730-Avulsion Nail Plate Single | $1,644.80 | $2,056.00 | — | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision of nail and nail matrix, partial or complete, for permanent removal | $472.80 | $591.00 | — | 18% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Permanent Nail Removal-WC Charge | $582.40 | $728.00 | — | 46% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750-Excision Nail & Matrix | $588.00 | $735.00 | — | 47% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 Excision of nail and nail matrix, partial or complete, for permanent removal | $472.80 | $591.00 | — | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 Permanent Nail Removal-WC Charge | $582.40 | $728.00 | — | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750-Excision Nail & Matrix | $588.00 | $735.00 | — | — | 20% |
| Prostate biopsy CPT 55700 55700 Biopsy, prostate; needle or punch, single or multiple, any approach | $621.60 | $777.00 | — | 18% below | 20% |
| Prostate biopsy inpatient CPT 55700 55700 Biopsy, prostate; needle or punch, single or multiple, any approach | $621.60 | $777.00 | — | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 64635 Destruction,neurolytic,paravertebral facet joint nerve,w/imaging;lumb/sac,single facet | $1,638.40 | $2,048.00 | — | 61% above | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 64635 Destruction,neurolytic,paravertebral facet joint nerve,w/imaging;lumb/sac,single facet | $1,638.40 | $2,048.00 | — | — | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 10120-Subcutaneous Tissue Simple | $267.20 | $334.00 | — | 6% above | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 Incision and removal of foreign body, subcutaneous tissues; simple | $283.20 | $354.00 | — | 12% above | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120-Subcutaneous Tissue Simple | $267.20 | $334.00 | — | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 Incision and removal of foreign body, subcutaneous tissues; simple | $283.20 | $354.00 | — | — | 20% |
| Short arm cast (elbow to hand) CPT 29075 29075 Application, cast; elbow to finger (short arm) | $269.60 | $337.00 | — | 55% above | 20% |
| Short arm cast (elbow to hand) CPT 29075 29075-Cast Application Elbow to Finger (short arm) | $400.00 | $500.00 | — | 129% above | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 29075 Application, cast; elbow to finger (short arm) | $269.60 | $337.00 | — | — | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 29075-Cast Application Elbow to Finger (short arm) | $400.00 | $500.00 | — | — | 20% |
| Short arm splint (forearm and hand) CPT 29125 29125 Application of Short Arm Splint | $196.80 | $246.00 | — | 61% above | 20% |
| Short arm splint (forearm and hand) CPT 29125 29125-Short Arm | $267.20 | $334.00 | — | 118% above | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125 Application of Short Arm Splint | $196.80 | $246.00 | — | — | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm | $267.20 | $334.00 | — | — | 20% |
| Short leg cast (below the knee) CPT 29405 29405 Application of short leg cast (below knee to toes) | $329.60 | $412.00 | — | 58% above | 20% |
| Short leg cast (below the knee) CPT 29405 29405-App of Short Leg Cast (below knee to toes) | $529.60 | $662.00 | — | 153% above | 20% |
| Short leg cast (below the knee) inpatient CPT 29405 29405 Application of short leg cast (below knee to toes) | $329.60 | $412.00 | — | — | 20% |
| Short leg cast (below the knee) inpatient CPT 29405 29405-App of Short Leg Cast (below knee to toes) | $529.60 | $662.00 | — | — | 20% |
| Short leg splint (calf to foot) CPT 29515 29515-Short Leg | $267.20 | $334.00 | — | 75% above | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg | $267.20 | $334.00 | — | — | 20% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface | $3,078.40 | $3,848.00 | — | 49% below | 20% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface | $3,078.40 | $3,848.00 | — | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm | $294.40 | $368.00 | — | 50% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Repair Superficial Wound 2.5 cm or less-WC Charge | $304.80 | $381.00 | — | 56% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; <2.5cm | $349.60 | $437.00 | — | 79% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm | $294.40 | $368.00 | — | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 Repair Superficial Wound 2.5 cm or less-WC Charge | $304.80 | $381.00 | — | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; <2.5cm | $349.60 | $437.00 | — | — | 20% |
| Skin biopsy, punch, one lesion CPT 11104 ZZZ11100 Biopsy of skin, subcutaneous tissue and/or mucous membrane; single lesion | $491.20 | $614.00 | — | 83% above | 20% |
| Skin biopsy, punch, one lesion CPT 11104 11104 PUNCH BIOPSY SKIN SINGLE LESION | $491.20 | $614.00 | — | 83% above | 20% |
| Skin biopsy, punch, one lesion CPT 11104 11104-Biopsy single skin lesion | $492.00 | $615.00 | — | 83% above | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 ZZZ11100 Biopsy of skin, subcutaneous tissue and/or mucous membrane; single lesion | $491.20 | $614.00 | — | — | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 11104 PUNCH BIOPSY SKIN SINGLE LESION | $491.20 | $614.00 | — | — | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 11104-Biopsy single skin lesion | $492.00 | $615.00 | — | — | 20% |
| Skin tag removal, up to 15 tags CPT 11200 11200 REMOVE SKIN TAGS <15 CHARGE | $560.00 | $700.00 | — | 325% above | 20% |
| Skin tag removal, up to 15 tags CPT 11200 11200-Removal Skin Tag up to 15 | $560.80 | $701.00 | — | 326% above | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200 REMOVE SKIN TAGS <15 CHARGE | $560.00 | $700.00 | — | — | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200-Removal Skin Tag up to 15 | $560.80 | $701.00 | — | — | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic TechFee | $479.20 | $599.00 | — | 11% above | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic | $479.20 | $599.00 | — | 11% above | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 SPINAL PUNCTURE LUMBAR ER SERV PROCEDURE | $791.20 | $989.00 | — | 83% above | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic TechFee | $479.20 | $599.00 | — | — | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic | $479.20 | $599.00 | — | — | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 SPINAL PUNCTURE LUMBAR ER SERV PROCEDURE | $791.20 | $989.00 | — | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; 2.6-7.5cm | $244.80 | $306.00 | — | 31% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm | $294.40 | $368.00 | — | 57% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Repair Superficial Wound 2.6 - 7.5 cm-WC Charge | $304.80 | $381.00 | — | 63% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; 2.6-7.5cm | $244.80 | $306.00 | — | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm | $294.40 | $368.00 | — | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 Repair Superficial Wound 2.6 - 7.5 cm-WC Charge | $304.80 | $381.00 | — | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm | $294.40 | $368.00 | — | 60% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple repair of wounds of face, ears, eyelids, nose, lips, mucous membra; <2.5cm | $298.40 | $373.00 | — | 62% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm | $294.40 | $368.00 | — | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 Simple repair of wounds of face, ears, eyelids, nose, lips, mucous membra; <2.5cm | $298.40 | $373.00 | — | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential Biopsy Skin Single Lesion(Shave, Scoop, saucerize, Curette) | $171.20 | $214.00 | — | at median | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion | $491.20 | $614.00 | — | 187% above | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential Biopsy of Skin, 1 lesion | $504.00 | $630.00 | — | 194% above | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Tangential Biopsy Skin Single Lesion(Shave, Scoop, saucerize, Curette) | $171.20 | $214.00 | — | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion | $491.20 | $614.00 | — | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Tangential Biopsy of Skin, 1 lesion | $504.00 | $630.00 | — | — | 20% |
| Thoracentesis with imaging guidance CPT 32555 32555-Thoracentesis w/ Imaging Guidance | $400.00 | $500.00 | — | 38% below | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 32555-Thoracentesis w/ Imaging Guidance | $400.00 | $500.00 | — | — | 20% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 42826 Tonsillectomy, primary or secondary; age 12 or over | $1,371.20 | $1,714.00 | — | 52% below | 20% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 42826 Tonsillectomy, primary or secondary; age 12 or over | $1,371.20 | $1,714.00 | — | — | 20% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 42825 Tonsillectomy, primary or secondary; younger than age 12 | $1,341.60 | $1,677.00 | — | 56% below | 20% |
| Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 42825 Tonsillectomy, primary or secondary; younger than age 12 | $1,341.60 | $1,677.00 | — | — | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) | $84.00 | $105.00 | — | 43% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552-Inject Trigger Point 1-2 Muscles | $1,644.80 | $2,056.00 | — | 1023% above | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) | $84.00 | $105.00 | — | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-Inject Trigger Point 1-2 Muscles | $1,644.80 | $2,056.00 | — | — | 20% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 58670 Laparoscopy, surgical; with fulguration of oviducts (with or w/o transection) | $2,238.40 | $2,798.00 | — | 56% below | 20% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 58670 Laparoscopy, surgical; with fulguration of oviducts (with or w/o transection) | $2,238.40 | $2,798.00 | — | — | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $785.60 | $982.00 | — | 4% above | 20% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $785.60 | $982.00 | — | — | 20% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 43251 Esophagogastroduodenoscopy removal of tumor(s) w/ snare technique | $1,556.80 | $1,946.00 | — | 88% above | 20% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 43251 Esophagogastroduodenoscopy removal of tumor(s) w/ snare technique | $1,556.80 | $1,946.00 | — | — | 20% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 43248 Esophagogastroduodenoscopy, flexible, transoral; w/ passage of dilator(s) through esophagus | $1,112.00 | $1,390.00 | — | 68% above | 20% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 43248 Esophagogastroduodenoscopy, flexible, transoral; w/ passage of dilator(s) through esophagus | $1,112.00 | $1,390.00 | — | — | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, collection of specimen brsh/floss | $722.40 | $903.00 | — | 9% below | 20% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, collection of specimen brsh/floss | $722.40 | $903.00 | — | — | 20% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 52356 Cystourethroscopy with ureteroscopy and/or pyeloscopy with lithotripsy incld insert of stent | $3,994.40 | $4,993.00 | — | 1% below | 20% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 52356 Cystourethroscopy with ureteroscopy and/or pyeloscopy with lithotripsy incld insert of stent | $3,994.40 | $4,993.00 | — | — | 20% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Vasectomy. | $4,855.20 | $6,069.00 | — | 298% above | 20% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Vasectomy. | $4,855.20 | $6,069.00 | — | — | 20% |
| Wart removal, up to 14 warts CPT 17110 17110 Destruction of benign lesions 1-14 lesions | $137.60 | $172.00 | — | 2% above | 20% |
| Wart removal, up to 14 warts CPT 17110 17110 - Destruction benign; up to 14 | $651.20 | $814.00 | — | 382% above | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 17110 Destruction of benign lesions 1-14 lesions | $137.60 | $172.00 | — | — | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 17110 - Destruction benign; up to 14 | $651.20 | $814.00 | — | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debridement Skin- SQ Tissue, 1st 20sqcm-WC Charge | $1,159.20 | $1,449.00 | — | 196% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm | $1,644.80 | $2,056.00 | — | 320% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 Debridement Skin- SQ Tissue, 1st 20sqcm-WC Charge | $1,159.20 | $1,449.00 | — | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm | $1,644.80 | $2,056.00 | — | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Charges -> 1-4 Hours | $719.20 | $899.00 | — | 51% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Charges -> 4-8 Hours | $719.20 | $899.00 | — | 51% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Charges -> < 1 hour | $719.20 | $899.00 | — | 51% above | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Charges -> < 1 hour | $719.20 | $899.00 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Charges -> 1-4 Hours | $719.20 | $899.00 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Charges -> 4-8 Hours | $719.20 | $899.00 | — | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction | $46.40 | $58.00 | — | 44% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction | $46.40 | $58.00 | — | — | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care, First 30-74 Min | $253.94 | $317.43 | — | 69% below | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Facility Level Critical Care Ill/Injured Patient Init 30-74 Min | $2,172.80 | $2,716.00 | — | 164% above | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 Critical Care, First 30-74 Min | $253.94 | $317.43 | — | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 Facility Level Critical Care Ill/Injured Patient Init 30-74 Min | $2,172.80 | $2,716.00 | — | — | 20% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 RT EEG w/Rec. Awake and Drowsy CHARGE | $972.80 | $1,216.00 | — | 217% above | 20% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram | $972.80 | $1,216.00 | — | 217% above | 20% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 RT EEG w/Rec. Awake and Drowsy CHARGE | $972.80 | $1,216.00 | — | — | 20% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Electroencephalogram | $972.80 | $1,216.00 | — | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93000 Electrocardiogram 12 Lead | $193.60 | $242.00 | — | 155% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG WITHOUT REPORT Charge | $193.60 | $242.00 | — | 155% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV Electrocardiogram 12 Lead | $193.60 | $242.00 | — | 155% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV ECG Acquisition | $193.60 | $242.00 | — | 155% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV ECG Acquisition | $193.60 | $242.00 | — | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 EKG WITHOUT REPORT Charge | $193.60 | $242.00 | — | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93000 Electrocardiogram 12 Lead | $193.60 | $242.00 | — | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV Electrocardiogram 12 Lead | $193.60 | $242.00 | — | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ED VISIT FOR E&M PATIENT, LEV 1, MAY NOT REQ PRESENCE OF PHYSICIAN OR OTHER, CC | $155.20 | $194.00 | — | 26% above | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 ED VISIT FOR E&M PATIENT, LEV 1, MAY NOT REQ PRESENCE OF PHYSICIAN OR OTHER, CC | $155.20 | $194.00 | — | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ED VISIT E&M PATIENT, LEV 2, REQ MED APPROP HSTRY/EXAM/MDM, CC | $279.20 | $349.00 | — | 69% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 ED VISIT E&M PATIENT, LEV 2, REQ MED APPROP HSTRY/EXAM/MDM, CC | $279.20 | $349.00 | — | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ED VISIT E&M PATIENT, LEV 3, REQ MED APPROP HSTRY/EXAM/LOW MDM, CC | $400.80 | $501.00 | — | 52% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 ED VISIT E&M PATIENT, LEV 3, REQ MED APPROP HSTRY/EXAM/LOW MDM, CC | $400.80 | $501.00 | — | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 ED VISIT E&M PATIENT, LEV 4, REQ MED APPROP HSTRY/EXAM/MODERATE MDM, CC | $771.20 | $964.00 | — | 84% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 ED VISIT E&M PATIENT, LEV 4, REQ MED APPROP HSTRY/EXAM/MODERATE MDM, CC | $771.20 | $964.00 | — | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ED VISIT E M PATIENT, LEV 5, REQ MED APPROP HSTRY/EXAM/HIGH MDM, CC | $1,727.20 | $2,159.00 | — | 229% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 ED VISIT E M PATIENT, LEV 5, REQ MED APPROP HSTRY/EXAM/HIGH MDM, CC | $1,727.20 | $2,159.00 | — | — | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 FAMILY PSYCHOTHERAPY W/ PATIENT PRESENT | $174.40 | $218.00 | — | 54% above | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy w/ patient present (conjoint) | $235.58 | $294.48 | — | 109% above | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy, conjoint psychotherapy, with patient present | $235.58 | $294.48 | — | 109% above | 20% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 FAMILY PSYCHOTHERAPY W/ PATIENT PRESENT | $174.40 | $218.00 | — | — | 20% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family psychotherapy w/ patient present (conjoint) | $235.58 | $294.48 | — | — | 20% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family psychotherapy, conjoint psychotherapy, with patient present | $235.58 | $294.48 | — | — | 20% |
| Family therapy without the patient, 50 minutes CPT 90846 90846 FAMILY PSYCHOTHERAPY W/OUT PATIENT PRESENT | $150.40 | $188.00 | — | 17% above | 20% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 FAMILY PSYCHOTHERAPY W/OUT PATIENT PRESENT | $150.40 | $188.00 | — | — | 20% |
| Group psychotherapy session CPT 90853 90853 GROUP PSYCHOTHERAPY | $51.20 | $64.00 | — | 47% below | 20% |
| Group psychotherapy session CPT 90853 90853 Group psychotherapy Charge | $60.00 | $75.00 | — | 38% below | 20% |
| Group psychotherapy session CPT 90853 90853 Group psychotherapy (other than of a multiple-family group) | $235.58 | $294.48 | — | 145% above | 20% |
| Group psychotherapy session inpatient CPT 90853 90853 GROUP PSYCHOTHERAPY | $51.20 | $64.00 | — | — | 20% |
| Group psychotherapy session inpatient CPT 90853 90853 Group psychotherapy Charge | $60.00 | $75.00 | — | — | 20% |
| Group psychotherapy session inpatient CPT 90853 90853 Group psychotherapy (other than of a multiple-family group) | $235.58 | $294.48 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 HYDRATE IV INFUSE 1ST HR CHARGE | $267.20 | $334.00 | — | 87% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - ED Hydration, first hour | $324.00 | $405.00 | — | 127% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR | $324.00 | $405.00 | — | 127% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 HYDRATE IV INFUSE 1ST HR CHARGE | $267.20 | $334.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - ED Hydration, first hour | $324.00 | $405.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR | $324.00 | $405.00 | — | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION 1ST HR Charge | $347.20 | $434.00 | — | 83% above | 20% |
| IV infusion of a medicine, first hour CPT 96365 96365-59 Infusion Initial Addl Site w/ Modification | $400.00 | $500.00 | — | 111% above | 20% |
| IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION INITIAL UP TO 1HR CHARGE | $400.00 | $500.00 | — | 111% above | 20% |
| IV infusion of a medicine, first hour CPT 96365 96365- ED IV tx, first hour | $400.00 | $500.00 | — | 111% above | 20% |
| IV infusion of a medicine, first hour CPT 96365 96365 COVID-19 Antibody INF Remdesivir | $420.00 | $525.00 | — | 122% above | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION 1ST HR Charge | $347.20 | $434.00 | — | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION INITIAL UP TO 1HR CHARGE | $400.00 | $500.00 | — | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365-59 Infusion Initial Addl Site w/ Modification | $400.00 | $500.00 | — | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365- ED IV tx, first hour | $400.00 | $500.00 | — | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 COVID-19 Antibody INF Remdesivir | $420.00 | $525.00 | — | — | 20% |
| IV push of a medicine, first drug CPT 96374 96374- ED Injection, single/initial | $136.00 | $170.00 | — | 39% above | 20% |
| IV push of a medicine, first drug CPT 96374 96374 INJ IV PUSH INITIAL CHARGE | $136.00 | $170.00 | — | 39% above | 20% |
| IV push of a medicine, first drug CPT 96374 96374-59 IV Push Initial Drug Addl Site w/ Modification | $136.00 | $170.00 | — | 39% above | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 96374 INJ IV PUSH INITIAL CHARGE | $136.00 | $170.00 | — | — | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 96374- ED Injection, single/initial | $136.00 | $170.00 | — | — | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 96374-59 IV Push Initial Drug Addl Site w/ Modification | $136.00 | $170.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Admin Injection Charge -> 96372: SUBQ/IM | $29.60 | $37.00 | — | 44% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 ED Subq/IM Injection | $85.60 | $107.00 | — | 62% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-59 SQ/IM Injection w/ Modification | $85.60 | $107.00 | — | 62% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-59 SQ/IM Injection w/ Modif Charge | $85.60 | $107.00 | — | 62% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Admin Injection Charge -> 96372: SUBQ/IM | $29.60 | $37.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-59 SQ/IM Injection w/ Modif Charge | $85.60 | $107.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-59 SQ/IM Injection w/ Modification | $85.60 | $107.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 ED Subq/IM Injection | $85.60 | $107.00 | — | — | 20% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psychiatric diagnostic evaluation - no medical services Charge | $224.00 | $280.00 | — | 106% above | 20% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psychiatric diagnostic evaluation | $235.58 | $294.48 | — | 116% above | 20% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 Psychiatric diagnostic evaluation - no medical services Charge | $224.00 | $280.00 | — | — | 20% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 Psychiatric diagnostic evaluation | $235.58 | $294.48 | — | — | 20% |
| New patient office visit, about 30 minutes CPT 99203 99203 Office/Outpatient Visit - New Patient, Level 3 (30-44 min) | $160.00 | $200.00 | — | 119% above | 20% |
| New patient office visit, about 30 minutes CPT 99203 99203 BH Office Visit New Pt. Level 3 | $322.45 | $403.06 | — | 341% above | 20% |
| New patient office visit, about 30 minutes CPT 99203 99203 New Patient- Detailed | $468.80 | $586.00 | — | 542% above | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office/Outpatient Visit - New Patient, Level 3 (30-44 min) | $160.00 | $200.00 | — | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 BH Office Visit New Pt. Level 3 | $322.45 | $403.06 | — | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 New Patient- Detailed | $468.80 | $586.00 | — | — | 20% |
| New patient office visit, about 45 minutes CPT 99204 99204 BH Office Visit New Pt. Level 4 | $322.45 | $403.06 | — | 253% above | 20% |
| New patient office visit, about 45 minutes CPT 99204 99204 Office/Outpatient Visit - New Patient, Level 4 (45-59 min) | $322.45 | $403.06 | — | 253% above | 20% |
| New patient office visit, about 45 minutes CPT 99204 99204 New Patient- Comprehensive Mod. Complexity | $680.80 | $851.00 | — | 646% above | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office/Outpatient Visit - New Patient, Level 4 (45-59 min) | $322.45 | $403.06 | — | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 BH Office Visit New Pt. Level 4 | $322.45 | $403.06 | — | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 New Patient- Comprehensive Mod. Complexity | $680.80 | $851.00 | — | — | 20% |
| New patient office visit, about 60 minutes CPT 99205 99205 Office/Outpatient Visit - New Patient, Level 5 (60 Min) | $320.00 | $400.00 | — | 195% above | 20% |
| New patient office visit, about 60 minutes CPT 99205 99205 New Patient- Comprehensive High Complexity | $680.80 | $851.00 | — | 528% above | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 Office/Outpatient Visit - New Patient, Level 5 (60 Min) | $320.00 | $400.00 | — | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 New Patient- Comprehensive High Complexity | $680.80 | $851.00 | — | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 BH Office Visit New Pt. Level 2 | $100.00 | $125.00 | — | 68% above | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office/Outpatient Visit - New Patient, Level 2 - 15-29 min | $253.94 | $317.43 | — | 327% above | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 New Patient- Expanded Problem Focused | $408.00 | $510.00 | — | 586% above | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 BH Office Visit New Pt. Level 2 | $100.00 | $125.00 | — | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office/Outpatient Visit - New Patient, Level 2 - 15-29 min | $253.94 | $317.43 | — | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 New Patient- Expanded Problem Focused | $408.00 | $510.00 | — | — | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 NUTRITION THERAPY INITIAL EACH 15 MIN CHARGE | $84.00 | $105.00 | — | 173% above | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 NUTRITION THERAPY INITIAL EACH 15 MIN CHARGE | $84.00 | $105.00 | — | — | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385 Preventive Evaluation, New Pt; 18-39 Yrs | $322.45 | $403.06 | — | 115% above | 20% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385 Preventive Evaluation, New Pt; 18-39 Yrs | $322.45 | $403.06 | — | — | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386 Preventive Evaluation, New Pt; 40-64 Yrs | $183.20 | $229.00 | — | 31% above | 20% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 Preventive Evaluation, New Pt; 40-64 Yrs | $183.20 | $229.00 | — | — | 20% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 Preventive Evaluation, New Pt; 65+ Yrs | $197.60 | $247.00 | — | 44% above | 20% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387 Preventive Evaluation, New Pt; 65+ Yrs | $197.60 | $247.00 | — | — | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Preventive Evaluation, Established Pt; 18-39 Yrs | $322.45 | $403.06 | — | 223% above | 20% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395 Preventive Evaluation, Established Pt; 18-39 Yrs | $322.45 | $403.06 | — | — | 20% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Preventive Evaluation, Established Pt; 40-64 Yrs | $140.80 | $176.00 | — | 19% above | 20% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 Preventive Evaluation, Established Pt; 40-64 Yrs | $140.80 | $176.00 | — | — | 20% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Evaluation, Established Pt; 65+ Yrs | $253.94 | $317.43 | — | 108% above | 20% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 Preventive Evaluation, Established Pt; 65+ Yrs | $253.94 | $317.43 | — | — | 20% |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy, 30 minutes with patient and/or family member | $100.00 | $125.00 | — | 16% above | 20% |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy, 30 min Charge | $240.00 | $300.00 | — | 179% above | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy, 30 minutes with patient and/or family member | $100.00 | $125.00 | — | — | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy, 30 min Charge | $240.00 | $300.00 | — | — | 20% |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy, 60 minutes with patient and/or family member | $279.20 | $349.00 | — | 156% above | 20% |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy, 60 min Charge | $280.00 | $350.00 | — | 157% above | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psychotherapy, 60 minutes with patient and/or family member | $279.20 | $349.00 | — | — | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psychotherapy, 60 min Charge | $280.00 | $350.00 | — | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office/Outpatient Visit - Established Patient, Level 5 (40-54 min). | $220.00 | $275.00 | — | 207% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Specialty Clinic Est Patient Level 5 | $220.00 | $275.00 | — | 207% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office/Outpatient Visit - Established Patient, Level 5 | $253.94 | $317.43 | — | 255% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Established Patient- Comprehensive High Complexity | $680.80 | $851.00 | — | 852% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office/Outpatient Visit - Established Patient, Level 5 (40-54 min). | $220.00 | $275.00 | — | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Specialty Clinic Est Patient Level 5 | $220.00 | $275.00 | — | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office/Outpatient Visit - Established Patient, Level 5 | $253.94 | $317.43 | — | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Established Patient- Comprehensive High Complexity | $680.80 | $851.00 | — | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/Outpatient Visit - Established Patient, Level 3 | $120.00 | $150.00 | — | 111% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 BH Office Visit Established Pt. Level 3 | $253.94 | $317.43 | — | 347% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Est. Patient- Expanded Problem Focus | $468.80 | $586.00 | — | 726% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Office/Outpatient Visit - Established Patient, Level 3 | $120.00 | $150.00 | — | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 BH Office Visit Established Pt. Level 3 | $253.94 | $317.43 | — | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Est. Patient- Expanded Problem Focus | $468.80 | $586.00 | — | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office/Outpatient Visit - Established Patient, Level 4 | $322.45 | $403.06 | — | 388% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 BH Office Visit Established Pt. Level 4 | $322.45 | $403.06 | — | 388% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Established Patient- Detailed | $680.80 | $851.00 | — | 931% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 BH Office Visit Established Pt. Level 4 | $322.45 | $403.06 | — | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Office/Outpatient Visit - Established Patient, Level 4 | $322.45 | $403.06 | — | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Established Patient- Detailed | $680.80 | $851.00 | — | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Est Pt Office Visit 10-19 Min | $68.00 | $85.00 | — | 31% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 BH TM Office Visit Established Pt. Level 2 | $80.00 | $100.00 | — | 54% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/Outpatient Visit - Established Patient, Level 2 | $322.45 | $403.06 | — | 521% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Established Patient- Problem Focused | $408.00 | $510.00 | — | 685% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Est Pt Office Visit 10-19 Min | $68.00 | $85.00 | — | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 BH TM Office Visit Established Pt. Level 2 | $80.00 | $100.00 | — | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office/Outpatient Visit - Established Patient, Level 2 | $322.45 | $403.06 | — | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Established Patient- Problem Focused | $408.00 | $510.00 | — | — | 20% |
| Spirometry (breathing test) CPT 94010 RT CHARGE PFT -> Spirometry | $299.20 | $374.00 | — | 137% above | 20% |
| Spirometry (breathing test) inpatient CPT 94010 RT CHARGE PFT -> Spirometry | $299.20 | $374.00 | — | — | 20% |
| Spirometry before and after a bronchodilator CPT 94060 RT CHARGE PFT -> Spirometry before & after | $396.00 | $495.00 | — | 92% above | 20% |
| Spirometry before and after a bronchodilator CPT 94060 RT CHARGE PFT | $396.00 | $495.00 | — | 92% above | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT CHARGE PFT -> Spirometry before & after | $396.00 | $495.00 | — | — | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT CHARGE PFT | $396.00 | $495.00 | — | — | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $228.80 | $286.00 | — | 128% above | 20% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy | $228.80 | $286.00 | — | — | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 AMB influenza vacc Charge -> 90694 vacc aiiv4 | $304.00 | $380.00 | — | 203% above | 20% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 AMB influenza vacc Charge -> 90653 influ triv adjuvant vacc im | $304.00 | $380.00 | — | 203% above | 20% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 AMB influenza vacc Codes -> 90694 vacc aiiv4 | $304.00 | $380.00 | — | 203% above | 20% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 AMB influenza vacc Charge -> 90694 vacc aiiv4 | $304.00 | $380.00 | — | — | 20% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 AMB influenza vacc Charge -> 90653 influ triv adjuvant vacc im | $304.00 | $380.00 | — | — | 20% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 AMB influenza vacc Codes -> 90694 vacc aiiv4 | $304.00 | $380.00 | — | — | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 AMB varicella Charge -> 0.5 mL varicella | $198.40 | $248.00 | — | 3% below | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 AMB varicella Charge -> 0.5 mL varicella | $198.40 | $248.00 | — | — | 20% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 IMMUN ADMIN EA ADDL INJ CLINIC | $168.00 | $210.00 | — | 75% above | 20% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 IMMUN ADMIN EA ADDL INJ CLINIC | $168.00 | $210.00 | — | — | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 AMB influenza vacc Charge -> 90656 no prsv 3+> | $60.00 | $75.00 | — | 100% above | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 AMB influenza vacc Charge -> 90656 no prsv 3+> | $60.00 | $75.00 | — | — | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 AMB hepatitis A vaccine Charge -> 0.5 mL hepatitis A vaccine | $68.00 | $85.00 | — | 23% below | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 AMB hepatitis A vaccine Charge -> 0.5 mL hepatitis A vaccine | $68.00 | $85.00 | — | — | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine | $280.00 | $350.00 | — | 10% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine | $280.00 | $350.00 | — | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 AMB DTAP-HIB-IPV CHARGE -> 0.5 mL DTaP-IPV/Hib | $50.40 | $63.00 | — | 21% below | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 AMB Tdap Charge -> Tdap (Adacel) | $267.60 | $334.50 | — | 319% above | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 AMB DTAP-HIB-IPV CHARGE -> 0.5 mL DTaP-IPV/Hib | $50.40 | $63.00 | — | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 AMB Tdap Charge -> Tdap (Adacel) | $267.60 | $334.50 | — | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Immunization Charge -> First Vaccine 90471 | $23.20 | $29.00 | — | 42% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 AMB Only Admin Charge -> Initial Admin Charge 90471 | $47.20 | $59.00 | — | 18% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471-Vaccine Administration | $104.00 | $130.00 | — | 160% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Immunization Charge -> First Vaccine 90471 | $23.20 | $29.00 | — | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 AMB Only Admin Charge -> Initial Admin Charge 90471 | $47.20 | $59.00 | — | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471-Vaccine Administration | $104.00 | $130.00 | — | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE TechFee | $32.80 | $41.00 | — | 23% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE TechFee | $32.80 | $41.00 | — | — | 20% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.